LIBERTY SELECT CYCLER ASSY(NON-VALUATED)
Report
- Report Number
- 0008030665-2026-00353
- Event Type
- Malfunction
- Date Received
- February 18, 2026
- Date of Event
- February 14, 2026
- Report Date
- March 23, 2026
- Manufacturer
- ERIKA DE REYNOSA, S.A. DE C.V.
- Product Code
- FKX
- UDI-DI
- 00840861102068
- PMA / PMN Number
- K222318
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VA, US
- Reporter Occupation
- 003
Narratives
PLANT INVESTIGATION: NO PARTS WERE RETURNED TO THE MANUFACTURER FOR PHYSICAL EVALUATION. A RECORDS REVIEW WAS PERFORMED ON THE REPORTED SERIAL NUMBER. AN INVESTIGATION OF THE DEVICE MANUFACTURING RECORDS WAS CONDUCTED BY THE MANUFACTURER. THERE WERE NO NON-CONFORMANCES, OR ANY ASSOCIATED REWORK IDENTIFIED DURING THE MANUFACTURING PROCESS WHICH COULD BE RELATED TO THE REPORTED EVENT. IN ADDITION, THE DEVICE HISTORY RECORD (DHR) REVIEW CONFIRMED THE RESULTS OF THE IN-PROGRESS AND FINAL QUALITY CONTROL (QC) TESTING MET ALL REQUIREMENTS. THE INVESTIGATION INTO THE CAUSE OF THE REPORTED PROBLEM WAS NOT ABLE TO BE CONFIRMED. A DEFINITIVE CONCLUSION REGARDING THE COMPLAINT INCIDENT CANNOT BE REACHED WITHOUT A PHYSICAL EXAMINATION OF THE COMPLAINT DEVICE.
PLANT INVESTIGATION: THE PLANT INVESTIGATION IS IN PROCESS. A SUPPLEMENTAL MDR WILL BE SUBMITTED UPON COMPLETION OF THIS ACTIVITY.
A PERITONEAL DIALYSIS (PD) PATIENT CONTACT STATED AFTER NOTICING THE FLUID THEY WERE NOT ABLE TO CLOSE THE CASSETTE DOOR (THEY HAD PRESSED NEXT). THEY REBOOTED THE CYCLER AND ENCOUNTERED A MWD WATCHDOG TIMER ERROR ALARM. A FLUID LEAK WAS NOTICED WHEN REMOVING THE CASSETTE ON STEP 9 OF TREATMENT. THE PATIENT WAS CONNECTED DURING INCIDENT AND FLUID WAS FOUND ON THE BOTTOM RIGHT INSIDE OF THE CASSETTE DOOR. NO ALARM WAS NOTED PRIOR TO THE FLUID LEAK. THE CONTACT STATED THE CASSETTE/TUBING DID NOT LOOK LIKE IT HAD ANY HOLES OR TEARS IN IT. THE MWD - WATCHDOG TIMER ERROR ALARM OCCURRED TWICE ON POWER UP. THE CONTACT ALSO NEEDED HELP WITH HOW TO GET THE CASSETTE DOOR TO CLOSE SINCE DOOR WAS STILL OPEN. THE CYCLER WAS REBOOTED AND THE PATIENT ALSO DISCONNECTED AND RECONNECTED THE POWER CORD AND THE ALARM CLEARED. THE PATIENT WAS ABLE TO CLOSE THE DOOR ON THE READY SCREEN AND WAS ADVISED TO WAIT 1 DAY BEFORE USING THE CYCLER AGAIN. THE CONTACT WAS ASKING IF THEY COULD CONTINUE USING CYCLER TONIGHT AND WAS ADVISED TO FOLLOW UP WITH THEIR PERITONEAL DIALYSIS REGISTERED NURSE (PDRN). UPON FOLLOW-UP, THE PDRN STATED A FLUID LEAK WAS DISCOVERED DURING STEP 9 - END OF TREATMENT AFTER TREATMENT WAS COMPLETED AND WHEN THE PATIENT CONTACT OPENED THE CASSETTE DOOR. THE CASSETTE DOOR WAS OPENED AND FLUID WAS DISCOVERED LEAKING FROM THE BOTTOM RIGHT INSIDE OF THE CASSETTE DOOR, IN THE PUMP MODULE AREA AND ON THE EXTERNAL OF THE CASSETTE. THE FILM ON THE BACK OF THE CASSETTE APPEARED INTACT AND THE FLUID LEAKED FROM AN UNKNOWN LOCATION. THE PATIENT WAS ABLE TO REVERT TO MANUALS TO COMPLETE TREATMENT ON THE NIGHT OF THE REPORTED EVENT. NO PATIENT ADVERSE EFFECTS WERE EXPERIENCED, AND NO MEDICAL INTERVENTION WAS REQUIRED. THE PDRN ALLOWED FOR THE CYCLER CASSETTE AREA TO DRY AND HAS RESUMED TREATMENT USING THE CYCLER WITHOUT FURTHER ISSUE. THE PDRN STATED THE CYCLER SET (CASSETTE) USED WAS DISCARDED AND WAS NO LONGER AVAILABLE TO BE RETURNED FOR INVESTIGATION.
A PERITONEAL DIALYSIS (PD) PATIENT CONTACT STATED AFTER NOTICING THE FLUID THEY WERE NOT ABLE TO CLOSE THE CASSETTE DOOR (THEY HAD PRESSED NEXT). THEY REBOOTED THE CYCLER AND ENCOUNTERED A MWD WATCHDOG TIMER ERROR ALARM. A FLUID LEAK WAS NOTICED WHEN REMOVING THE CASSETTE ON STEP 9 OF TREATMENT. THE PATIENT WAS CONNECTED DURING INCIDENT AND FLUID WAS FOUND ON THE BOTTOM RIGHT INSIDE OF THE CASSETTE DOOR. NO ALARM WAS NOTED PRIOR TO THE FLUID LEAK. THE CONTACT STATED THE CASSETTE/TUBING DID NOT LOOK LIKE IT HAD ANY HOLES OR TEARS IN IT. THE MWD - WATCHDOG TIMER ERROR ALARM OCCURRED TWICE ON POWER UP. THE CONTACT ALSO NEEDED HELP WITH HOW TO GET THE CASSETTE DOOR TO CLOSE SINCE DOOR WAS STILL OPEN. THE CYCLER WAS REBOOTED AND THE PATIENT ALSO DISCONNECTED AND RECONNECTED THE POWER CORD AND THE ALARM CLEARED. THE PATIENT WAS ABLE TO CLOSE THE DOOR ON THE READY SCREEN AND WAS ADVISED TO WAIT 1 DAY BEFORE USING THE CYCLER AGAIN. THE CONTACT WAS ASKING IF THEY COULD CONTINUE USING CYCLER TONIGHT AND WAS ADVISED TO FOLLOW UP WITH THEIR PERITONEAL DIALYSIS REGISTERED NURSE (PDRN). UPON FOLLOW-UP, THE PDRN STATED A FLUID LEAK WAS DISCOVERED DURING STEP 9 - END OF TREATMENT AFTER TREATMENT WAS COMPLETED AND WHEN THE PATIENT CONTACT OPENED THE CASSETTE DOOR. THE CASSETTE DOOR WAS OPENED AND FLUID WAS DISCOVERED LEAKING FROM THE BOTTOM RIGHT INSIDE OF THE CASSETTE DOOR, IN THE PUMP MODULE AREA AND ON THE EXTERNAL OF THE CASSETTE. THE FILM ON THE BACK OF THE CASSETTE APPEARED INTACT AND THE FLUID LEAKED FROM AN UNKNOWN LOCATION. THE PATIENT WAS ABLE TO REVERT TO MANUALS TO COMPLETE TREATMENT ON THE NIGHT OF THE REPORTED EVENT. NO PATIENT ADVERSE EFFECTS WERE EXPERIENCED, AND NO MEDICAL INTERVENTION WAS REQUIRED. THE PDRN ALLOWED FOR THE CYCLER CASSETTE AREA TO DRY AND HAS RESUMED TREATMENT USING THE CYCLER WITHOUT FURTHER ISSUE. THE PDRN STATED THE CYCLER SET (CASSETTE) USED WAS DISCARDED AND WAS NO LONGER AVAILABLE TO BE RETURNED FOR INVESTIGATION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 365486 | LIBERTY SELECT CYCLER ASSY(NON-VALUATED) | SYSTEM, PERITONEAL, AUTOMATIC DELIVERY | FKX | ERIKA DE REYNOSA, S.A. DE C.V. | 00840861102068 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 63 YR | Female | LIBERTY CYCLER SET.| LIBERTY CYCLER SET.| PD SOLUTION.| PD SOLUTION. |