FDA Adverse Event Malfunction Summary report: N

CARDINALHEALTH

MDR report key: 19102592 · Received April 13, 2024

Report

Report Number
3005670221-2024-00049
Event Type
Malfunction
Date Received
April 13, 2024
Report Date
April 13, 2024
Manufacturer
JIANGSU CAINA MEDICAL CO., LTD.
Product Code
FMF
UDI-DI
10192253033519
PMA / PMN Number
K113091
Removal / Correction Number
Z-0853-2024
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

RETURNED SAMPLE WAS RECEIVED. 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 NO PUMP COMPATABILITY ISSUES WITH THIS PRODUCT WERE RECEIVED BEFORE. A RECALL WAS CONDUCTED BY DISTRIBUTOR CARDINAL HEALTH 200 LLC WITH RECALL NUMBER Z-0853-2024. THE CORRECTIVE ACTION PUTTING THE CAUTION "FOR MANUAL USE OR NOT FOR PUMP USE" ON ALL SYRINGES' LABELING OF K113091 WILL BE TAKEN.

Description of Event or Problem · 0

THE CUSTOMER REPORTED THEY NOTICED THAT THE SYRINGES HAVE THE SAME REF#, HOWEVER ARE CARDINAL BRANDED PACKAGING. THE PLUNGER ON THE CARDINAL BRAND ARE A LITTLE BIT LARGER AND THIS IS CAUSING THE INFUSION PUMPS TO REFUSE THE SYRINGE UNLESS THEY ARE "APPROVED" FOR USE IN THE INFUSION PUMPS. THE CUSTOMER IS ASKING IF WE HAVE DOCUMENTATION OR INFORMATION THAT THESE SYRINGES ARE APPROVED FOR USE IN THE INFUSION PUMPS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
779121 CARDINALHEALTH SYRINGE FMF JIANGSU CAINA MEDICAL CO., LTD. 221201 10192253033519

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other