FDA Adverse Event Malfunction Summary report: N

ARROW CANNON II PLUS REPLACEMENT HUB SET

MDR report key: 20143170 · Received September 5, 2024

Report

Report Number
9680794-2024-00848
Event Type
Malfunction
Date Received
September 5, 2024
Date of Event
August 10, 2024
Report Date
August 12, 2024
Manufacturer
ARROW INTERNATIONAL LLC
Product Code
NFK
PMA / PMN Number
K020430
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

QN# (B)(4). THE CUSTOMER RETURNED ONE THREADED COMPRESSION CAP, CONNECTOR ASSEMBLY, AND COMPRESSION SLEEVE FOR EVALUATION. SIGNS OF USE WERE OBSERVED ON THE COMPRESSION CAP. VISUAL INSPECTION OF THE SAMPLE CONFIRMED A CRACK ALONG THE MOLDING SEAM OF THE COMPRESSION CAP. VISUAL AND MICROSCOPIC EXAMINATION REVEALED THAT THE GREEN COMPRESSION SLEEVE CONTAINED DAMAGE FROM BECOMING PINCHED BETWEEN THE THREADS OF THE COMPRESSION CAP AND CONNECTOR ASSEMBLY. EVALUATION OF THE CONNECTOR ASSEMBLY REVEALED THAT IT DOES NOT MATCH THE CUSTOMER REPORTED MATERIAL. ANALYSIS OF THE DEFECTIVE COMPONENT, THE COMPRESSION FITTING, REVEALED THAT IT IS A STANDARD COMPONENT BETWEEN CHRONIC HEMODIALYSIS KITS AND REPLACEMENT SETS. THEREFORE, DESPITE THE CONNECTOR ASSEMBLY DISCREPANCY, SINCE THE CUSTOMER REPORT WAS CONFIRMED, THE DEFECT WAS INVESTIGATED. R & D WAS PREVIOUSLY CONTACTED AS A PART OF THIS COMPLAINT INVESTIGATION. THEY CONFIRMED THAT OVER-TIGHTENING OF THE COMPRESSION CAP DURING USE LIKELY CAUSED OR CONTRIBUTED TO THIS EVENT. THE INSTRUCTIONS FOR USE (IFU) PROVIDED WITH THE KIT INFORMS THE USER, "GREEN COMPRESSION SLEEVE MUST BE PRESENT WHEN THREADING COMPRESSION CAP ONTO HUB CONNECTION ASSEMBLY. FAILURE TO DO SO MAY RESULT IN AIR EMBOLISM, BLOOD LOSS, OR CATHETER SEPARATION". THE IFU ALSO STATES, "THREAD COMPRESSION CAP ONTO HUB CONNECTION ASSEMBLY FIRMLY, BUT DO NOT OVER TIGHTEN. THERE SHOULD BE NO THREADS VISIBLE ON HUB CONNECTION ASSEMBLY." THE REPORT OF A DAMAGED COMPRESSION CAP WAS CONFIRMED THROUGH COMPLAINT INVESTIGATION OF THE RETURNED SAMPLE. VISUAL AND MICROSCOPIC ANALYSIS REVEALED A CRACK IN THE COMPRESSION CAP. THREAD IMPRINTS WERE OBSERVED ON THE GREEN COMPRESSION SLEEVE, WHICH LIKELY OCCURRED FROM BEING PINCHED BETWEEN THE CONNECTOR ASSEMBLY AND COMPRESSION CAP. BASED ON THE SAMPLE RECEIVED, THE REPORT FROM THE CUSTOMER, AND THE PRIOR COMMENTS FROM R & D, UNINTENTIONAL USE ERROR LIKELY CAUSED OR CONTRIBUTED TO THIS EVENT. TELEFLEX WILL CONTINUE TO MONITOR AND TREND FOR REPORTS IF THIS NATURE.

Additional Manufacturer Narrative · 0

(B)(4). UDI NOT COMPLETE AS THE LOT# WAS NOT PROVIDED BY CUSTOMER.

Description of Event or Problem · 0

IT WAS REPORTED THAT: "THE WHITE THREADED COMPRESSION CAP HAD A TEAR ALONG THE ENTIRE LENGTH OF THE CAP FOR NO APPARENT REASON. AS A RESULT, BLOOD WAS ALSO LEAKING OUT AND THE ATTACHMENT WAS HEAVILY ENCRUSTED. THE CATHETER WAS IN SITU FOR 12 MONTHS WITHOUT ANY PROBLEMS. THE DAMAGED HUB WAS REMOVED AND REPLACED WITH A REPLACEMENT HUB. CATHETER SHOWED NO LEAKS AND COULD BE USED FOR DIALYSIS. SO FAR UNEVENTFUL IN USE. THE EVENT HAD NO INFLUENCE ON THE PATIENT'S HEALTH SITUATION. THE PATIENT IS REPORTED AS BEING GOOD AND STABLE.".

Description of Event or Problem · 0

IT WAS REPORTED THAT: "THE WHITE THREADED COMPRESSION CAP HAD A TEAR ALONG THE ENTIRE LENGTH OF THE CAP FOR NO APPARENT REASON. AS A RESULT, BLOOD WAS ALSO LEAKING OUT AND THE ATTACHMENT WAS HEAVILY ENCRUSTED. THE CATHETER WAS IN SITU FOR 12 MONTHS WITHOUT ANY PROBLEMS. THE DAMAGED HUB WAS REMOVED AND REPLACED WITH A REPLACEMENT HUB. CATHETER SHOWED NO LEAKS AND COULD BE USED FOR DIALYSIS. SO FAR UNEVENTFUL IN USE. THE EVENT HAD NO INFLUENCE ON THE PATIENT'S HEALTH SITUATION. THE PATIENT IS REPORTED AS BEING GOOD AND STABLE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1386124 ARROW CANNON II PLUS REPLACEMENT HUB SET KIT, REPAIR, CATHETER, HEMODI NFK ARROW INTERNATIONAL LLC

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown NOT REPORTED.| NOT REPORTED.