FDA Adverse Event Malfunction Summary report: N

1424643-2017-05005

MDR report key: 6463436 · Received April 6, 2017

Report

Report Number
1424643-2017-05005
Event Type
Malfunction
Date Received
April 6, 2017
Report Date
March 9, 2017
Manufacturer
COV LP/LLC, CRYSTAL LAKE, MFG
Product Code
MMK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SUBMIT DATE: 4/6/2017. AN INVESTIGATION IS CURRENTLY UNDER WAY; UPON COMPLETION THE RESULTS WILL BE FORWARDED.

Additional Manufacturer Narrative · 1

THE DEVICE HISTORY RECORDS DATA WAS REVIEWED FOR LOT # 173917 AND NO INTERNAL REJECTS WERE FOUND DURING PRODUCTION OF THE LOT. THE POTENTIAL ROOT CAUSE FOR THE REPORTED CONDITION IS CUSTOMER MISUSE. THE CONTAINER WAS FILLED ABOVE THE FILL LINE AS PER COMPLAINT DESCRIPTION. THERE IS A WARNING ON THE LABEL NOT TO OVER FILL WHICH WAS NOT FOLLOWED DURING USE. BASED ON THE EXISTING CONTROLS, THE INTERNAL REJECT AND THE COMPLAINT HISTORY REVIEW, NO FORMAL INVESTIGATION IS REQUIRED AT THIS TIME. THIS WILL BE USED FOR TRACKING AND TRENDING PURPOSES. THIS ISSUE HAS BEEN DETERMINED TO BE AN ISOLATED EVENT DUE TO CUSTOMER MISUSE. THE CONTAINER WAS FILLED ABOVE THE FILL LINE AS PER EVENT DESCRIPTION. THERE IS NO HARM OR INJURY REPORTED FOR THE COMPLAINT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

THE CUSTOMER REPORTS THAT THE SHARPS CONTAINER HAS BEEN PUNCTURED.

Description of Event or Problem · 1

THE CUSTOMER REPORTS THAT THE SHARPS CONTAINER HAS BEEN PUNCTURED. (CUSTOMER MISUSE)-FROM (B)(4) THE CUSTOMER STATES; OF HEARING OF A SHARPS CONTAINER BEING PUNCTURED. IT'S CLEAR FROM THE WARNING ON THE LABEL NOT TO OVER FILL IT. THE CUSTOMER JUST WANTED TO MAKE SURE THE MANUFACTURER AND YOU ARE AWARE OF THIS IN CASE IT WOULD ISOLATED INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
248418 MMK COV LP/LLC, CRYSTAL LAKE, MFG 065 00173917

Patients

Seq Age Sex Outcome Treatment
1