FDA Adverse Event Malfunction Summary report: N

CARDINAL HEALTH

MDR report key: 19095209 · Received April 12, 2024

Report

Report Number
3005670221-2024-00014
Event Type
Malfunction
Date Received
April 12, 2024
Report Date
April 12, 2024
Manufacturer
JIANGSU CAINA MEDICAL CO., LTD.
Product Code
FMF
UDI-DI
10192253034677
PMA / PMN Number
K113091
Removal / Correction Number
Z-0855-2024
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE RETURNED SAMPLE IS UNAVAILABLE FOR EVALUATION. THE DHR OF THIS LOT WAS REVIEWED WITHOUT ANY ISSUE. THE DESIGN HISTORY FILE AND 510K SUBMISSION WERE REVIEWED. THIS SYRINGE IS DESIGNED FOR MANUAL USE ONLY, NOT FOR PUMP USE. FOR MANUAL USE OR NOT FOR PUMP USE WAS NOT PRESENTED ON ANY LABELING OF THIS PRODUCT. THE COMPLIANT HISTORY WAS REVIEWED FOUR PUMP COMPATABILITY ISSUES WITH THIS PRODUCT WERE RECEIVED BEFORE. A RECALL WAS CONDUCTED BY DISTRIBUTOR CARDINAL HEALTH 200 LLC WITH RECALL NUMBER Z-0855-2024. THE CORRECTIVE ACTION PUTTING THE CAUTION "FOR MANUAL USE OR NOT FOR PUMP USE" ON ALL SYRINGES' LABELING OF K113091 WILL BE TAKEN. A FOLLOW-UP REPORT WILL BE SUBMITTED IF ANY ADDITIONAL INFORMATION FROM THE RECEIVED SAMPLES.

Description of Event or Problem · 0

IT WAS REPORTED ANONYMOUSLY BY HEALTH SCIENCE UNIV THAT THE CARDINAL HEALTH MONOJECT 20ML REF: 118200777 SYRINGE IS "SLIGHTLY DIFFERENT" COMPARED TO THE COVIDIEN MONOJECT 20ML SYRINGE REF: 118200777. IT WAS NOTED THAT THE CARDINAL HEALTH MONOJECT 20ML SYRINGE CANNOT BE DETECTED BY THE SYRINGE PUMP. THERE WAS PATIENT INVOLVEMENT BUT NO HARM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1470954 CARDINAL HEALTH SYRINGE FMF JIANGSU CAINA MEDICAL CO., LTD. 230202 10192253034677

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other