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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: IVA SEAL STERL 36MM RED 1000-B; CONTAINER, I.V.

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IVA SEAL STERL 36MM RED 1000-B; CONTAINER, I.V. Back to Search Results
Model Number CP3009R
Device Problem Material Separation (1562)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 07/09/2021
Event Type  malfunction  
Manufacturer Narrative
The complainant indicated that the device will not be returned for evaluation; therefore, a failure analysis is not available, and we are not able to determine the relationship between this device and the cause for this event.As part of our manufacturing process, all device history records are reviewed and approved by quality, prior to release of product.If additional information or the sample is received, the investigation will be reopened and responded to accordingly.
 
Event Description
The customer reported the material of the iva seal 36 mm foil seals for the cefuroxime dose vials caps has deteriorated.The foils cannot be removed from the top of the cap in one piece, as the stripping strip remains in the hand after which it is difficult to get the final foil off the cap.There has been no problem with that foil in the past.
 
Manufacturer Narrative
There were no samples received with this complaint therefore an examination of the condition reported could not be made.From a root cause analysis perspective, the product is made to self-destruct when being removed from vials.There is a dual warning system in which seals self-destruct upon attempted removal, and needle punctures are highly visible in the laminated foil.This is to make it evident if the seal is tampered with.The slits on the seal help to ensure the product tears.Per the governing procedure for the product if upon peeling the iva seal from the container, there is evidence of the iva seal ripping, tearing, deforming or otherwise unusable.The results of the manufacturing facility investigation determined, based on the description received, the product worked as designed.No corrective or preventative actions are needed.We will continue to trend this issue for future occurrences as part of the complaint review process.
 
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Brand Name
IVA SEAL STERL 36MM RED 1000-B
Type of Device
CONTAINER, I.V.
MDR Report Key12206133
MDR Text Key264946783
Report Number1219103-2021-00332
Device Sequence Number1
Product Code KPE
UDI-Device Identifier10884527006182
UDI-Public10884527006182
Combination Product (y/n)N
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,user f
Type of Report Initial,Followup
Report Date 09/08/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/21/2021
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator No Information
Device Model NumberCP3009R
Device Catalogue NumberCP3009R
Device Lot Number912313X
Was Device Available for Evaluation? No
Date Manufacturer Received07/09/2021
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Type of Device Usage N
Patient Sequence Number1
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