HEPARIN I.V. FLUSH SYRINGE

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other report with the FDA on 2018-05-18 for HEPARIN I.V. FLUSH SYRINGE manufactured by Medefil, Inc..

Event Text Entries

[109106894] During manual visual inspection of the culled rejects from automated (eisai) inspection of the filled syringes for product: heparin lock flush, lot #h118248n on (b)(6) 2018, thirteen syringes were discovered to have pin holes in the yellow tip caps. Inventory and batch records were reviewed to identify potentially defective yellow tip cap lots and the finished product batches where these yellow tip cap lots were used. It was discovered that the following lots released to the market using same lots of tip cap used in lot #h118248n. Batch number: h118165n - heparin i. V. Flush syringe; 500 units/5 ml; 5 ml fill in 12 ml syringe, catalog number: mih-3335; h118174n - heparin i. V. Flush syringe; 500 units/5 ml; 5 ml fill in 12 ml syringe, mih-3335; h118183n - heparin i. V. Flush syringe; 500 units/5 ml; 5 ml fill in 12 ml syringe, mih-3335; h118190n - heparin i. V. Flush syringe; 300 units/3 ml; 3 ml fill in 6 ml syringe, mih-3323; h118191n - heparin i. V. Flush syringe; 500 units/5 ml; 5 ml fill in 12 ml syringe, mih-3335; h118200n - heparin i. V. Flush syringe; 500 units/5 ml; 5 ml fill in 12 ml syringe, mih-3335; h118206n - heparin i. V. Flush syringe; 300 units/3 ml; 3 ml fill in 12 ml syringe, mih-3335; h118216n - heparin i. V. Flush syringe; 300 units/3 ml; 3 ml fill in 12 ml syringe, mih-3333; h118220n - heparin i. V. Flush syringe; 500 units/5 ml; 5 ml fill in 12 ml syringe, mih-3335. Medefil, inc has initiated an investigation for the above mentioned finished product lots that are shipped from our warehouse and the investigation is still underway.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1423982-2018-00002
MDR Report Key7526349
Report SourceOTHER
Date Received2018-05-18
Date of Report2018-06-14
Date of Event2018-05-11
Date Added to Maude2018-05-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. PRADEEP AGGARWAL
Manufacturer Street405 WINDY POINT DRIVE GLENDALE HEIGHTS
Manufacturer CityIL 60139
Manufacturer CountryUS
Manufacturer Postal60139
Manufacturer Phone6306814600
Manufacturer G1MEDEFIL, INC.
Manufacturer Street250 WINDY POINT DRIVE GLENDALE HEIGHTS
Manufacturer CityIL 60139
Manufacturer CountryUS
Manufacturer Postal Code60139
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameHEPARIN I.V. FLUSH SYRINGE
Generic NameHEPARIN I.V. FLUSH SYRINGE
Product CodeNZW
Date Received2018-05-18
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerMEDEFIL, INC.
Manufacturer Address250 WINDY POINT DRIVE GLENDALE HEIGHTS IL 60139 US 60139


Patients

Patient NumberTreatmentOutcomeDate
101. Life Threatening; 2. Other 2018-05-18

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