FDA Adverse Event Malfunction Summary report: N

OTHER ACCESSORIES

MDR report key: 25180194 · Received May 15, 2026

Report

Report Number
8021545-2026-07708
Event Type
Malfunction
Date Received
May 15, 2026
Report Date
April 16, 2026
Manufacturer
ABBVIE INC
Product Code
FPA
PMA / PMN Number
UNKNOWN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

/ INITIAL 3 OF 3 BASED ON THE AVAILABLE INFORMATION, THIS EVENT IS DEEMED TO BE REPORTABLE MALFUNCTION. REQUEST WAS PERFORMED FOR ADDITIONAL INFORMATION INCLUDING LOT NUMBER; HOWEVER, LOT NUMBER WAS NOT PROVIDED. A COMPLAINT INVESTIGATION WAS INITIATED UNDER COMPLAINT INVESTIGATION. UNFORTUNATELY, NO SPECIFIC LOT NUMBER WAS IDENTIFIED, WHICH LIMITS THE ABILITY TO TRACE OR ANALYZE A PARTICULAR ITEM. TO DATE NO ADDITIONAL INFORMATION HAS BEEN RECEIVED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, A FOLLOW-UP REPORT WILL BE SUBMITTED. FDA REGISTRATION NUMBER REPORTING SITE: 8021545 MANUFACTURING SITE: 8021545.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT EXPERIENCED THREE INFUSION SETS CANNULAS HAD A LEAK ON FIRST EVENT- END OF (B)(6) 2026, SECOND EVENT -1ST WEEK OF (B)(6) 2026, THIRD EVENT- (B)(6) 2026.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
334152 OTHER ACCESSORIES Set, administration, intravascular FPA ABBVIE INC INFUSION DEVICES - UNKNOWN ICD UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown