EMPTY LIFECARE CONTAINER 100 ML SIZE
Report
- Report Number
- 9615050-2026-00117
- Event Type
- Malfunction
- Date Received
- February 20, 2026
- Date of Event
- January 1, 2026
- Report Date
- May 2, 2026
- Manufacturer
- ICU MEDICAL COSTA RICA LTD.
- Product Code
- KPE
- UDI-DI
- 10887787006831
- 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 THREE OPENED/UNUSED. LIST #079510470, 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 BAGS WERE FILLED WITH STERILE WATER USING ICU MEDICAL PROVIDED MATERIALS WHICH INCLUDED A PLUM SET, A STERILE WATER BAG, A CH-10, AND A SPIROS TO REPLICATE THE BAGS BEING FULL TO CHECK FOR PARTICULATES. UNDER BRIGHT LIGHTS NO PARTICULATES WERE OBSERVED. THE FLUID FROM THE THREE 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 THREE SETS. 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 MANUFACTURING 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. CORRECTED INFORMATION CAN BE FOUND IN B5 AND SECTION D10 CONCOMITANT PRODUCT.
CUSTOMER REPORTED INTERACTION NUMBER (B)(6). IT IS UNCLEAR WHAT THIS NUMBER IS. B3 - DATE OF EVENT - THE DATE OF EVENT IS UNKNOWN, AND (B)(6) 2026 HAS BEEN USED AS A PLACEHOLDER. THE DEVICE HAS BEEN RECEIVED FOR EVALUATION. THE INVESTIGATION IS PENDING COMPLETION.
ON AN UNSPECIFIED DATE, WITH KETAMINE BATCH 51161 AND 50958, PARTICULATE MATTER WAS IDENTIFIED IN THE EMPTY LIFECARE CONTAINER 100 ML SIZE CONTAINER. THERE WAS NO PATIENT INVOLVEMENT. THIS EMDR REFLECTS THE SECOND OF TWO OCCURRENCES.
A COMPLAINT WAS RECEIVED REGARDING EMPTY LIFECARE CONTAINER 100 ML SIZE IN WHICH IT WAS STATED THE PREPARATION FOR FENTANYL (BATCH 50958) 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 |
|---|---|---|---|---|---|---|---|
| 18890 | EMPTY LIFECARE CONTAINER 100 ML SIZE | CONTAINER, I.V. | KPE | ICU MEDICAL COSTA RICA LTD. | 14512283 | 10887787006831 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |