It was reported that the cap of the introducer (griff / handle) came off during preparation for treatment.Customer change the product since it is not possible to use it.No harm to patient was reported.The production history record (dhr) of the affected be-pvl 2555 with lot# 3000275040 was reviewed on 2023-04-10.According to the dhr result, the product be-pvl 2555 passed the defined manufacturing and final release specifications.There is no indication on manufacturing issues.The review of the non-conformities has been performed.It does not show any non-conformity in regards to the batch numbers of reported components and failure.Further, the incoming inspection reports of the affected components griff (batch # 3000199908) and introducer (batch # 3000237283) were reviewed on 2023-04-10.The griff was checked visually for particles, pressure marks, rills, streaks, sinks, fat, dirt, blur, cords, scratches, burrs, bubbles and also measured for diameter (inner).The introducer was checked visually for ridges, sharp edges, cracks, streaks, dirt, spots, bubbles and also measured for diameter (outer).All tests were passed as per specifications.The reported failure was identified as part of the current risk management file (dms#(b)(4), v01) and the most probable causes are associated to: 1.Manufacturing: - inappropriate assembly of components.2.Logistics: - mechanical damage of product due to vibration and impact during transport and storage.- loosening of handle from introducer due to vibration and impact during transport and storage.3.User: - loosening of handle from introducer during insertion of introducer into cannula due to mechanical loads.Due to the fact that the customer changed the hls cannula with a new one, the complaint could be confirmed.The occurrence rate was calculated for the reported failure and product and it was determined that this is not a systemic issue.Therefore, no remedial action is required.The occurrence rate related to the reported issue is currently being monitored as part of maquet cardiopulmonary¿s trending program and additional investigations or corrections will be implemented in case of adverse trending.
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