EMPTY LIFECARE CONTAINER 250 ML SIZE
Report
- Report Number
- 9615050-2026-00114
- Event Type
- Malfunction
- Date Received
- February 20, 2026
- Date of Event
- January 1, 2026
- Report Date
- May 4, 2026
- Manufacturer
- ICU MEDICAL COSTA RICA LTD.
- Product Code
- KPE
- UDI-DI
- 10887787006855
- PMA / PMN Number
- K771228
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- KS, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
RECEIVED FIVE (5) USED. LIST #079510471, EMPTY LIFECARE CONTAINER 100 ML SIZE. AS RECEIVED, NO DAMAGE OR ANOMALIES NOTED. THE BAGS WERE EXAMINED UNDER BRIGHT LIGHT AND NO EVIDENCE OF PARTICULATES WAS OBSERVED. RECEIVED FIFTEEN (15) PHOTOS FROM THE CUSTOMER OF VARIOUS BAGS WITH POSSIBLE PARTICULATES CIRCLED BY THE CUSTOMER WITH WRITTEN DESCRIPTIONS. THE FLUID FROM THE FIVE (5) BAGS WAS FLUSHED AND COLLECTED IN A VACUUM FILTRATION SYSTEM. THE FILTER PAPER WAS EXAMINED UNDER A MICROSCOPE AT 10X MAGNIFICATION TO CHECK FOR PARTICULATES FROM THE BAG AND FLUID. THERE WERE NO RESIDUAL PARTICLES ON THE FILTER PAPER ON FIVE (5) BAGS. THE SAMPLES WERE SENT TO AUSTIN FOR AN FTIR ANALYSIS. THE ANALYSIS SHOWED THAT PARTICULATE MATTER WAS PRESENT ON THE FILTER PAPER WHEN OBSERVED UNDER HIGHER MAGNIFICATION. THE PARTICULATE MATTER OBSERVED WERE COMPOSED OF CELLULOSE AND OLEAMIDE. THE COMPLAINT OF PARTICULATE MATTER CAN BE CONFIRMED. PARTICULATE MATTER IDENTIFIED DURING INVESTIGATION WAS CONSISTENT WITH CELLULOSE-BASED FIBERS AND OLEAMIDE MATERIALS COMMONLY ASSOCIATED WITH PACKAGING AND POLYMER PROCESSING AIDS. BASED ON THE AVAILABLE INFORMATION, THE MOST PROBABLE SOURCE IS RELATED TO ENVIRONMENTAL OR MATERIAL HANDLING FACTORS RATHER THAN A SPECIFIC MANUFACTURING DEFECT. THE COSTA RICA AND AUSTIN TEAMS IMPLEMENTED PROCESS ENHANCEMENTS AND INSPECTION IMPROVEMENTS TO FURTHER REDUCE THE POTENTIAL FOR PARTICULATE INTRODUCTION. THE LOT HISTORY WAS REVIEWED AND NO NONCONFORMITIES WERE IDENTIFIED THAT MAY HAVE CONTRIBUTED TO THE REPORTED COMPLAINT.
CUSTOMER REPORTED INTERACTION NUMBER: (B)(4). IT IS UNCLEAR WHAT THIS NUMBER IS. B3: DATE OF EVENT - THE DATE OF EVENT IS UNKNOWN, AND 01 JAN 2026 HAS BEEN USED AS A PLACEHOLDER. THE DEVICE HAS BEEN RECEIVED FOR EVALUATION. THE INVESTIGATION IS PENDING COMPLETION.
A COMPLAINT WAS RECEIVED REGARDING EMPTY LIFECARE CONTAINER 100 ML SIZE IN WHICH IT WAS STATED THE PREPARATION FOR FENTANYL (BATCH: 50944) WAS INSPECTED AND PARTICULATE MATTER WAS FOUND IN THE LIFECARE CONTAINER. THERE WAS NO PATIENT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 18983 | EMPTY LIFECARE CONTAINER 250 ML SIZE | CONTAINER, I.V. | KPE | ICU MEDICAL COSTA RICA LTD. | 14512283 | 10887787006855 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |