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