MAUDE MDR 7526349

MDR report key
7526349
Report number
1423982-2018-00002
Event key
0
Event type
3
Date of event
2018-05-11
Date received
2018-05-18
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR. PRADEEP AGGARWAL
Address
405 WINDY POINT DRIVE GLENDALE HEIGHTS IL 60139 US
Phone
630-630-6306
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HEPARIN I.V. FLUSH SYRINGEHEPARIN I.V. FLUSH SYRINGEMEDEFIL, INC.NZWY Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12018-05-1801. L; 2. O

Event Narratives#

D

Patient 1

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.