FDA Adverse Event Malfunction Summary report: N

ACCUVEIN AV500 VEIN VISUALIZATION SYSTEM

MDR report key: 18171348 · Received November 17, 2023

Report

Report Number
MW5148283
Event Type
Malfunction
Date Received
November 17, 2023
Date of Event
October 16, 2023
Report Date
November 16, 2023
Manufacturer
ACCUVEIN, INC.
Product Code
KZA
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
NY, US
Reporter Occupation
501
Health Professional
N

Narratives

Description of Event or Problem · 0

CASE (B)(4); REPORTED ON 9/27/2023 BY CONTACT (B)(6) HOSPITAL. CASE DESCRIPTION: DOES NOT CHARGE ON KNOWN WORKING CC500; WHEN AV500 IS PLACED IN CC500 THE LED TURNS ON, BUT LCD STAYS OFF. AV500 LEFT TO CHARGE OVERNIGHT AND DID NOT GAIN BATTERY LIFE. BIOMED SAID HE NOTICED A BURNED PLASTIC SMELL; UNIT IS NOT HOT TO TOUCH, AND NO ONE WAS HARMED. CASE (B)(6); REPORTED ON 10/16/2023 BY CONTACT (B)(6) HOSPITAL. CASE DESCRIPTION: HAS BURNED CHARGING PINS, SMELLS LIKE BURNED PLASTIC, NO ONE WAS HARMED. BIOMED TOSSED CRADLES [NOTE THE PLURAL] AWAY THOSE WERE ALSO DAMAGED AND MELTED ALSO TOSSED POWER SUPPLIES. ROOT CAUSE OF THE PROBLEM (IF KNOWN): UNKNOWN AT THIS TIME. A CAPA, 23-000040 WAS OPENED IN THE ACCUVEIN QUALITY MANAGEMENT SYSTEM ON 2023.11.02. IT IS EXPECTED THE PROBABLE CAUSE AND PROXIMAL CAUSE IS HUMAN PERFORMANCE ERROR, AS THE ACCUVEIN-PROVIDED POWER SUPPLIES (PS310, PS410, AND PS510) CANNOT, BY DESIGN, SERVE AS THE ROOT CAUSE OF THESE MALFUNCTIONS. NOTE: THE COMPLAINANT NEVER MENTIONED THE MODEL NUMBERS OF THE POWER SUPPLIES (WHICH SHOULD HAVE BEEN PS510), YET THEY WERE COGNIZANT ENOUGH TO LIST THE MODEL NUMBERS OF THE CHARGING CRADLES; I.E., CC500. FACTORS THAT MAY CONTRIBUTE TO PRODUCT RISK (I.E. DEVICE DESIGN, MANUFACTURING PROBLEMS OR USER ERROR): HUMAN PERFORMANCE ERROR; ACCUVEIN SUSPECTS THE PROBABLE CAUSE IS THE USE OF UNAPPROVED EXTERNAL POWER SUPPLIES, THE RESULT IS AN INCORRECT VOLTAGE WAS SUPPLIED TO THE CC500 CHARGING CRADLE. REFERENCE REPORT: MW5148284.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1991766 ACCUVEIN AV500 VEIN VISUALIZATION SYSTEM DEVICE, VEIN LOCATION, LIQUID CRYSTAL KZA ACCUVEIN, INC. AV500 WMR056888

Patients

Seq Age Sex Outcome Treatment
1 Unknown