As reported, while installing a cook bakri postpartum balloon with rapid instillation components, the tip of the 50 cc syringe broke in the three-way stopcock.This failure happened twice with two like devices.A third like device was used to complete the procedure.The complainant did not report any adverse effects on the patient due to this occurrence.Additional information has been requested but is not available at this time.
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Blank fields on this form indicate the information is unknown or unavailable.Event description: as reported, while installing a cook bakri postpartum balloon with rapid instillation components, the tip of the 50 cc syringe broke in the three-way stopcock.This failure happened twice with two like devices with the same patient.Estimated blood loss information was not available.The patient was hemodynamically stable at the time of the failures.The patient did not require hospitalization or prolonged hospitalization due to this occurrence.The occurrence did not create the need for any medical or surgical intervention.A third like device was used to complete the procedure and hemostasis was achieved.The complainant did not report any adverse effects on the patient due to this occurrence.Investigation ¿ evaluation.A visual inspection of the returned device was conducted.A document based investigation was also performed including a review of complaint history, device history record (dhr), the instructions for use (ifu), and quality control procedures.One cook bakri postpartum balloon with rapid instillation components was returned for evaluation.Visual inspection confirms what appears to be a syringe broken off inside the three-way stopcock.A review of the device history record found no non-conformances related to the reported failure mode.A review of complaint history records shows no other complaints associated with the complaint device lot.Because there were no related non-conformances, adequate inspection activities have been established, there is objective evidence that the dhr was fully executed, and no other lot related complaints that have been received from the field, it was concluded that there is no evidence that nonconforming product exists in house or in the field.Review of the device history record, complaint history, relevant manufacturing documents, and device failure analysis does provides evidence that the device was manufactured to specification.Cook also reviewed product labeling.The ifu packaged with the device contains the following in relation to the reported failure mode: how supplied "upon removal from the package, inspect the product to ensure no damage has occurred." based on the information provided, inspection of the returned device, and the results of the investigation, the most probable cause for this event could not be established.The appropriate personnel have been notified.Cook will continue to monitor for similar complaints.Per the risk assessment no further action is required.This report is required by the fda under 21 cfr part 803 and is based on unconfirmed information submitted by others.Neither the submission of this report nor any statement contained herein is intended to be an admission that any cook device is defective or malfunctioned, that a death or serious injury occurred, nor that any cook device caused, contributed to, or is likely to cause or contribute to a death or serious injury if a malfunction occurred.
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