BEUDAMED
    FDA Enforcement Class II Terminated

    DeRoyal Sterile Custom Kits packaged as a Piggy Back with the BD PosiFlush SF Saline Flush Syringe, labeled as follows: a. H* Vein Pack Pgybk, 89-6209.03 b. H* Vein Pack, 89-6209.04 c. PICC Line Tray Pgybk, 89-6150.12 d. Umbilical Arterial Cath, 89-9370.01 e. Port Pack Pgybk, 89-8748.03 f. Port Pack Pgybk, 89-8748.04 g. Central Line Pack Pgybk, 89-8448.02 h.CV Insertion Kit II Pgybk, 89-9417.03 I. CV Insertion Kit II Pgybk, 89-9417.04 j. Right Heart Introducer Pgybk, 89-8495.04 k. Vein Pack Pgybk, 89-10400.01

    Recall: Z-1963-2020 · Reported May 20, 2020

    Enforcement

    Recall Number
    Z-1963-2020
    Event ID
    85594
    Classification
    Class II
    Status
    Terminated
    Product Type
    Devices
    Firm
    DeRoyal Industries Inc
    Voluntary / Mandated
    Voluntary: Firm initiated
    Initial Notification
    E-Mail
    Report Date
    May 20, 2020
    Initiation Date
    April 24, 2020
    Classification Date
    May 11, 2020
    Termination Date
    May 26, 2022
    Address
    200 Debusk Ln, N/A, Powell, TN, 37849-4703, United States

    Description

    DeRoyal Sterile Custom Kits packaged as a Piggy Back with the BD PosiFlush SF Saline Flush Syringe, labeled as follows: a. H* Vein Pack Pgybk, 89-6209.03 b. H* Vein Pack, 89-6209.04 c. PICC Line Tray Pgybk, 89-6150.12 d. Umbilical Arterial Cath, 89-9370.01 e. Port Pack Pgybk, 89-8748.03 f. Port Pack Pgybk, 89-8748.04 g. Central Line Pack Pgybk, 89-8448.02 h.CV Insertion Kit II Pgybk, 89-9417.03 I. CV Insertion Kit II Pgybk, 89-9417.04 j. Right Heart Introducer Pgybk, 89-8495.04 k. Vein Pack Pgybk, 89-10400.01

    Reason

    DeRoyal manufactured procedure packs using BDPosiFlush syringes which were subsequently recalled due holes in the packaging.

    Code Info

    a. 89-6209.03: Lot number: 49935860 exp 4/1/2021 b. 89-6209.04: Lot numbers: 51458994 exp 2/1/2022, 51220521 exp 2/1/2022, 51382467 exp 2/1/2022, 51836975 exp 4/1/2022, 51006728 exp 10/1/2021 c. 89-6150.12: Lot numbers: 49896872 exp 11/1/2021, 50381438 exp 12/1/2021, 50129726 exp 12/1/2021, 51602562 exp 2/1/2022, 51347371 exp 2/1/2022, 51788951 exp 4/1/2022, 50784528 exp 8/1/2021, 51006787 exp 1/1/2022 d. 89-9370.01: Lot numbers: 50110742 exp 7/1/2020, 50601672 exp 7/1/2020, 51008408 exp 5/1/2021, 51284787 exp 8/1/2021 e. 89-8748.03: Lot Number 49989657 exp 12/1/2021 f. 89-8748.04: Lot numbers: 50275125 exp 12/1/2021, 50129064 exp 12/1/2021, 51791631 exp 12/1/2021, 51434765 exp 2/1/2022, 51925556 exp 4/1/2022, 50879543 exp 1/1/2022, 51030197 exp 1/1/2022 g. 89-8448.02: Lot numbers: 50477253 exp 10/1/2020, 50129072 exp 1/1/2021, 50570141 exp 2/1/2021 h.89-9417.03: Lot number: 50375468 exp 10/1/2020 i. 89-9417.04: Lot numbers: 51604074 exp 5/1/2021, 51733028 exp 5/1/2021, 52033357 exp 5/1/2021, 50630967 exp 2/1/2021, 50829255 exp 4/1/2021 j. 89-8495.04: Lot numbers: 50612902 exp 10/1/2020, 51791800 exp 2/1/2021, 50905238 exp 2/1/2021, 50919891 exp 2/1/2021, 51252849 exp 2/1/2021 k. 89-10400.01: Lot numbers: 51556261 exp 2/1/2021, 51881274 exp 2/1/2022, 51974930 exp 2/1/2022, 51473449 exp 10/1/2021, 51984388 exp 4/1/2022

    Distribution

    US distribution in the states of TN, MD, MN, ND, NY, FL, MA, RI

    Quantity

    352 trays with 7923 syringes