FDA Adverse Event Malfunction Summary report: N

VIAL SUREPATH COLLECTION KIT 500

MDR report key: 19524718 · Received June 12, 2024

Report

Report Number
3008007472-2024-00009
Event Type
Malfunction
Date Received
June 12, 2024
Date of Event
May 14, 2024
Report Date
May 22, 2024
Manufacturer
TRIPATH IMAGING, INC
Product Code
MKQ
UDI-DI
10382904914520
PMA / PMN Number
P970018
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE CUSTOMER COMPLAINT IS FOR ONE (1) VIAL OF 491452 LOT NUMBER 3157024 THAT WAS EMPTY AND NOT ABLE TO BE RECLOSED. A 12-MONTH COMPLAINT REVIEW WAS PERFORMED. THERE HAVE BEEN NO PREVIOUS COMPLAINTS AGAINST 491452 FOR LEAKAGE LOT 3157024. BD PERFORMS REGULAR TRENDING TO DETERMINE IF A CORRECTIVE AND PREVENTATIVE ACTION (CAPA) IS REQUIRED, AND AS OF THIS TIME THE THRESHOLD FOR A CAPA HAS NOT BEEN REACHED. BD WILL CONTINUE TO MONITOR AND EVALUATE TRENDS. MATERIAL 491452 IS MANUFACTURED AT THE BD MEBANE, NC FACILITY ON A VALIDATED AUTOMATED FILLING LINE REFERRED TO AS THE SHIBUYA VIAL FILLING LINE. THE REVIEW OF THE MANUFACTURING DHR FOR LOT NUMBER 3157024 IDENTIFIED THAT MANUFACTURING BEGAN ON 08JUN2023 AND A TOTAL OF (B)(6) KITS WERE PRODUCED WITH NO ISSUES OBSERVED. DURING THE PRODUCTION PROCESS, A TOTAL OF (B)(6) VIALS WERE SUBJECT TO LEAK TESTING UNDER VACUUM WITH NO LEAKING VIALS OR CRACKED CAPS OBSERVED. AN ANALYSIS OF THE RETAINS WAS PERFORMED AND DID NOT IDENTIFY ANY CRACKS, LEAKS, OR OTHER ABNORMALITIES. NO PICTURES WERE PROVIDED, AND NO SAMPLES WERE RETURNED. THE COMPLAINT IS NOT CONFIRMED.

Description of Event or Problem · 0

REPORT 2 OF 2. IT WAS REPORTED WHEN USING THE VIAL SUREPATH COLLECTION KIT 500, THE SAMPLES LEAKED OUT OF THE VIAL. THERE WAS NO HEALTH IMPACT OR CONSEQUENCES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
373555 VIAL SUREPATH COLLECTION KIT 500 PROCESSOR, CERVICAL CYTOLOGY SLIDE, AUTOMATED MKQ TRIPATH IMAGING, INC 3157024 10382904914520

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown