FDA Adverse Event
Malfunction
Summary report: N
MEDEX¿ CLEAR-CUFF PRESSURE INFUSOR
MDR report key: 6641076
·
Received June 14, 2017
Report
- Report Number
- 3012307300-2017-01256
- Event Type
- Malfunction
- Date Received
- June 14, 2017
- Date of Event
- May 12, 2017
- Report Date
- June 14, 2017
- Manufacturer
- SMITHS MEDICAL ASD, INC.
- Product Code
- KZD
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- EZ
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
POTENTIAL LOT NUMBERS - 1375586, 2318203, 2520828,2641407, 2731314, 3031202, 3166207, 3277472, 3290524, 3330092, AND 3333628. CUSTOMER HAS NOT RETURNED THE DEVICE TO THE MANUFACTURER FOR DEVICE EVALUATION. IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MANUFACTURER WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION.
Description of Event or Problem · 1
IT WAS REPORTED THAT AIR LEAKED FROM A MEDEX¿ CLEAR-CUFF PRESSURE INFUSOR, AND THE DEVICE DOES NOT HOLD PRESSURE. IT WAS ALSO NOTED THAT THERE WERE VISIBLE CRACKS ON THE "LIGHT BLUE PLASTIC PART". NO INJURY WAS REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 421525 | MEDEX¿ CLEAR-CUFF PRESSURE INFUSOR | INFUSOR, PRESSURE, FOR I.V. BAGS | KZD | SMITHS MEDICAL ASD, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |