FDA Adverse Event Malfunction Summary report: N

TUBING SETS

MDR report key: 19938140 · Received August 8, 2024

Report

Report Number
8010762-2024-00395
Event Type
Malfunction
Date Received
August 8, 2024
Date of Event
August 2, 2024
Report Date
February 14, 2025
Manufacturer
MAQUET CARDIOPULMONARY GMBH
Product Code
DWE
PMA / PMN Number
K080592
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 SAMPLE WAS INVESTIGATED AT MAQUET CARDIOPULMONARY GMBH LABORATORY ON 2024-10-02. A VISUAL INSPECTION WAS PERFORMED AND FOUND THAT THE CLAIMED QUADROX.I ADULT SHOWED NO DAMAGES LIKE CRACKS, SCRATCHES, DEFORMATIONS, IMPACT POINTS OR BREAKS. BY PERFORMING THE LEAK TEST ON THE BLOOD SIDE, A LEAK IMMEDIATELY OCCURRED AT THE LUER OF THE BLOOD OUTLET CONNECTOR. THE CAUSE OF THE LEAKAGE IS A CRACK ON THE LUER OF THE DEAIRING. THE COMPLAINT COULD THEREFORE BE CONFIRMED. A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN FURTHER INFORMATION BECOMES AVAILABLE.

Additional Manufacturer Narrative · 0

A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN FURTHER INFORMATION BECOMES AVAILABLE.

Additional Manufacturer Narrative · 0

IT WAS REPORTED THAT BLOOD LEAKAGE WAS DETECTED IN THE ARTERIAL LINE OF OXYGENATOR. THE FAILURE DETECTED DURING TREATMENT. IT WAS REPORTED THIS FAILURE REPEATEDLY OCCURS ON LUER LOCK CONNECTION OF FLOOD BLOOD OUTLET. CUSTOMER CONCERNS ABOUT THE DESIGN DIFFERENCE OF LUER LOCK CONNECTORS BETWEEN BLOOD INLET AND OUTLET. NO HARM TO ANY PERSON HAS BEEN REPORTED. THE SAMPLE WAS INVESTIGATED AT MAQUET CARDIOPULMONARY GMBH LABORATORY ON 2024-10-02. A VISUAL INSPECTION WAS PERFORMED AND FOUND THAT THE CLAIMED QUADROX.I ADULT SHOWED NO DAMAGES LIKE CRACKS, SCRATCHES, DEFORMATIONS, IMPACT POINTS OR BREAKS. BY PERFORMING THE LEAK TEST ON THE BLOOD SIDE, A LEAK IMMEDIATELY OCCURRED AT THE LUER OF THE BLOOD OUTLET CONNECTOR. THE CAUSE OF THE LEAKAGE IS A CRACK ON THE LUER OF THE DEAIRING. THE COMPLAINT COULD THEREFORE BE CONFIRMED, BUT NOT RELATED WITH THE BLOOD OUTLET CONNECTOR ITSELF, THE FAILURE WAS RELATED TO LLM CONNECTOR (700000331). BASED ON THE INVESTIGATION RESULTS, THERE WAS NOT ANY NON-CONFORMITIES DETECTED FOR THE BLOOD OUTLET CONNECTOR¿S ITSELF. HOWEVER, THE FAILURE WAS FOUND AS RELATED WITH LUER CONNECTOR AND THEREFORE THIS COMPLAINT COULD BE CONFIRMED. THE PROBABLE CAUSE OF THE FAILURE WAS FOUND AS RELATED WITH MATERIAL. THE PRODUCTION HISTORY RECORD (DHR) OF THE AFFECTED QUADROX-I SMALL ADULT WITH LOT # 3000336654 WAS REVIEWED ON 2024-08-19. ACCORDING TO THE DHR RESULTS, THE PRODUCT QUADROX-I SMALL ADULT PASSED THE DEFINED MANUFACTURING AND FINAL RELEASE SPECIFICATIONS. THE PRODUCTION HISTORY RECORD (DHR) OF THE AFFECTED BE-HQV 19312 WITH LOT# 3000358313 WAS REVIEWED ON 2024-09-20. ACCORDING TO THE DHR RESULT, THE PRODUCT BE-HQV 19312 PASSED THE DEFINED MANUFACTURING AND FINAL RELEASE SPECIFICATIONS. A NON-CONFORMITY RECORD HAS BEEN INITIATED FOR THE RELATED FAILURE CRACK & SCRATCH ON 700000330 ¿ 700000331 CONNECTORS. THIS NON-CONFORMITY RECORD WAS INITIATED DUE TO A NOTIFICATION WAS PERFORMED BY MCP AND CAUSED BY ANOTHER PRODUCT GROUP COMPLAINT INVESTIGATION'S RESULTS. AS THE FAILURE WAS FOUND AS SAME WITH THE NON-CONFORMITY RECORD, FURTHER INVESTIGATION OF THE CAUSE AND ACTIONS WILL BE DETERMINED & PERFORMED WITHIN THIS NON-CONFORMITY. THE OCCURRENCE RATE WAS CALCULATED FOR THE REPORTED FAILURE AND PRODUCT AND IT WAS DETERMINED THAT THIS IS NOT A SYSTEMIC ISSUE. THEREFORE, NO REMEDIAL ACTION IS REQUIRED. THE OCCURRENCE RATE RELATED TO THE REPORTED ISSUE IS CURRENTLY BEING MONITORED AS PART OF MAQUET CARDIOPULMONARY¿S TRENDING PROGRAM AND ADDITIONAL INVESTIGATIONS OR CORRECTIONS WILL BE IMPLEMENTED IN CASE OF ADVERSE TRENDING.

Description of Event or Problem · 0

COMPLAINT # (B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT LEAKAGE WAS DETECTED IN THE ARTERIAL LINE OF OXYGENATOR AND THE LEAKAGE OF BLOOD IS DRIP BY DROP. THE FAILURE DETECTED DURING TREATMENT. NO HARM OR DEATH TO ANY PERSON WAS REPORTED. COMPLAINT # (B)(4).

Description of Event or Problem · 0

COMPLAINT # (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2402964 TUBING SETS TUBING, PUMP, CARDIOPULMONARY BYPASS DWE MAQUET CARDIOPULMONARY GMBH BE-HQV 19312 3000358313

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown