FDA Adverse Event Malfunction Summary report: N

VACUETTE® TUBE 3 ML 9NC COAGULATION SODIUM CITRATE 3.2% 13X75, UNKNOWN

MDR report key: 23863420 · Received December 22, 2025

Report

Report Number
1125230-2025-00056
Event Type
Malfunction
Date Received
December 22, 2025
Report Date
December 22, 2025
Manufacturer
GREINER BIO-ONE NA INC.
Product Code
GIM
PMA / PMN Number
K971221
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

COMPLAINT (B)(4): SAMPLES HAVE BEEN REQUESTED FROM THE CUSTOMER BUT HAVE NOT YEAR BEEN RECEIVED AT THE TIME OF THIS REPORT. IF AND WHEN CUSTOMER SAMPLES ARE RECEIVED, THEY WILL BE EVALUATED AS PART OF THE COMPLAINT INVESTIGATION. UPON COMPLETION OF THE COMPLAINT INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

Additional Manufacturer Narrative · 0

(B)(4): NO SAMPLES WERE RECEIVED FOR EVALUATION. THE COMPLAINT CANNOT BE DETERMINED. CORRECTED DATA: H6: INVESTIGATION FINDINGS, INVESTIGATION CONCLUSION; H11: MANUFACTURER NARRATIVE.

Description of Event or Problem · 0

CUSTOMER ADVISED THEY ARE HAVING ISSUES WITH BLUE TOPS UNDERFILLING TO THE INDICATOR. CUSTOMER IDENTIFIED LOT B250833T AND OCCURRENCES ACROSS OTHER UNKNOWN LOTS. CUSTOMER ADVISED MANY OF THE TUBES THAT WERE PROBLEMATIC HAVE GONE PAST THEIR STORAGE LIMITS AND WERE DISCARDED, SO THEY ARE IMPOSSIBLE TO OBTAIN AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1662744 VACUETTE® TUBE 3 ML 9NC COAGULATION SODIUM CITRATE 3.2% 13X75, UNKNOWN EVACUATED BLOOD COLLECTION TUBE GIM GREINER BIO-ONE NA INC. 454351, UNKNOWN B250833T, UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown