FDA Adverse Event Malfunction Summary report: N

ACCU-CHEK FLEXLINK PLUS INFUSION SET

MDR report key: 22093648 · Received May 28, 2025

Report

Report Number
3003442380-2025-09402
Event Type
Malfunction
Date Received
May 28, 2025
Date of Event
February 25, 2025
Report Date
May 27, 2025
Manufacturer
UNOMEDICAL DEVICES S.A. DE C.V.
Product Code
FPA
PMA / PMN Number
K143446
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION - THIS MDR IS BEING SUBMITTED TO INCLUDE THE BELOW: H6: INVESTIGATION RESULTS UNDER TYPE OF INVESTIGATION, INVESTIGATION FINDINGS, INVESTIGATION CONCLUSIONS H11: INVESTIGATION SUMMARY. THE REFERENCE SAMPLES FOR THE LOT 6001283 HAVE ALREADY BEEN PREVIOUSLY TESTED IN THE (B)(4) ON 16/OCT/2024. TEST RESULTS: THE REFERENCE SAMPLES WERE VISUALLY INSPECTED AND TESTED FOR FLOW AND LEAK. ALL TEST RESULTS WERE WITHIN SPECIFICATIONS AS PER THE TEST REPORT DATABASE (B)(4) COMPLAINT TEST REPORT. DEVICE HISTORY RECORD (DHR) REVIEW: THE LOT 6001283 WAS MANUFACTURED ACCORDING TO THE WORK INSTRUCTION (WI) VERSION 15 MANUFACTURED IN THE MULTIVAC 07, ON 05/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. CANNULA DHR REVIEW: THE LOT 3D02666 WAS MANUFACTURED ACCORDING TO THE WI VERSION 35 MANUFACTURED IN THE LINE 02, ON 03/MAY/2023, WITH A TOTAL OF (B)(4) UNITS. REVIEW OF THE DHR SHOWED THAT ALL RELEVANT TESTS REQUIRED DURING THE RELATED PROCESSES HAD BEEN FULFILLED AND MET THE REQUIREMENTS. NO DEVIATION WERE IDENTIFIED, NO MAINTENANCE EVENTS WERE RECORDED. TRENDING: A QUERY WAS RUN IN DATABASE ON 26/MAY/2025 AGAINST MALFUNCTION CODE IDD-PMC02.01 AND LOT 6001283 AND OTHER COMPLAINT HAS BEEN REGISTERED IN DATABASE FOR THE SAME LOT AND MALFUNCTION CODE. CONCLUSION SUMMARY OF COMPLAINT INVESTIGATION: AS A RESULT OF THE FOLLOWING: NO DEFECT ON TESTS FOR REFERENCE SAMPLES, NO NON-CONFORMANCE (NC) RAISED DURING PRODUCTION RELATED TO COMPLAINT CODE, AND ANOTHER COMPLAINT HAS BEEN RECEIVED ON THE LOT IN QUESTION AND MALFUNCTION CODE, NO FURTHER ACTIONS ARE REQUIRED. THIS COMPLAINT WILL NOT REQUIRE FURTHER ROOT CAUSE INVESTIGATION NOR CORRECTIVE AND PREVENTIVE ACTION (CAPA) PLAN. THEREFORE, THIS ISSUE WILL BE MONITORED THROUGH THE POST MARKET SURVEILLANCE ACTIVITIES.

Description of Event or Problem · 0

REFERENCE NUMBER (B)(4). EVENT OCCURRED IN BRAZIL. IT WAS REPORTED THAT THE PATIENT FACED EVENT OF LEAKAGE OF CANNULA ON (B)(6) 2025. THE SITE WAS PATIENT'S ABDOMEN. NO FURTHER INFORMATION AVAILABLE.

Description of Event or Problem · 0

TO DATE NO ADDITIONAL PATIENT OR EVENT DETAILS HAVE BEEN RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1014362 ACCU-CHEK FLEXLINK PLUS INFUSION SET ACCU-CHEK FLEXLINK CANNULA 6 10 PCS FPA UNOMEDICAL DEVICES S.A. DE C.V. 06593941001 6001283

Patients

Seq Age Sex Outcome Treatment
1 45 YR Female