FDA Adverse Event Malfunction Summary report: N

EMPTY LIFECARE CONTAINER 250 ML SIZE

MDR report key: 24466425 · Received February 27, 2026

Report

Report Number
9615050-2026-00143
Event Type
Malfunction
Date Received
February 27, 2026
Date of Event
February 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
PHARMACIST
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

RECEIVED FIVE (5) USED. LIST #079510470, EMPTY LIFECARE CONTAINER 250 ML SIZE AND THREE (3) OPENED/UNUSED. LIST #079510470, EMPTY LIFECARE CONTAINER 250 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 THREE (3) EMPTY 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 EIGHT (8) TOTAL 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 EIGHT (8) BAGS. THE SAMPLES WERE SENT TO AUSTIN FOR AN FTIR (FOURIER TRANSFORM INFRARED) 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.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION A SECTION AND B5.

Additional Manufacturer Narrative · 0

THE DEVICE HAS BEEN RECEIVED FOR EVALUATION; HOWEVER, INVESTIGATION IS NOT YET COMPLETE. ADDITIONAL CONTACT INFORMATION: (B)(6).

Description of Event or Problem · 0

THERE WAS NO PATIENT INVOLVEMENT AND NO PATIENT HARM ASSOCIATED WITH THIS EVENT.

Description of Event or Problem · 0

THE EVENT OCCURRED ON AN UNSPECIFIED DATE AND INVOLVED AN EMPTY LIFECARE CONTAINER 250 ML SIZE. IT WAS REPORTED THAT THEY HAVE BEEN SEEING PARTICULATE MATTER INSIDE BAG. THERE WAS NO REPORTED PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
266501 EMPTY LIFECARE CONTAINER 250 ML SIZE CONTAINER, I.V. KPE ICU MEDICAL COSTA RICA LTD. 14443192 10887787006855

Patients

Seq Age Sex Outcome Treatment
1