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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COOK INC GUARDIA¿ ACCESS EMBRYO TRANSFER CATHETER; MQF CATHETER, ASSISTED REPRODUCTION

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COOK INC GUARDIA¿ ACCESS EMBRYO TRANSFER CATHETER; MQF CATHETER, ASSISTED REPRODUCTION Back to Search Results
Model Number G34783
Device Problem Unsealed Device Packaging (1444)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 05/11/2023
Event Type  malfunction  
Manufacturer Narrative
E1: customer name and address = (b)(6).Postal code: (b)(6).This report includes information known at this time.A follow-up report will be submitted should additional relevant information become available.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.
 
Event Description
As reported, the seal to a guardia¿ access embryo transfer catheter packaging is not completely sealed.Half of the inner catheter is stuck in the sealing of the package.Another device of the same type was used to complete the procedure.No adverse effects were reported.
 
Manufacturer Narrative
Blank fields on this form indicate the information is unknown, unavailable, or unchanged.Event summary as reported, the seal to a guardia¿ access embryo transfer catheter packaging is not completely sealed.Half of the inner catheter is stuck in the sealing of the package.Another device of the same type was used to complete the procedure.No adverse effects were reported.Investigation ¿ evaluation a document based investigation was performed including a review of complaint history, device history record (dhr), instructions for use (ifu), and manufacturing instructions (mi), as well as a visual inspection of the device were conducted.One device was returned with the outer packaging.The transfer catheter inner pouch seal had been compromised on the proximal end.There was a portion of a guide catheter that was caught in the seal and cut.A review of the device history record found one similar nonconformance for 4 devices recorded for the lot.The non-conforming devices were scrapped prior to lot release.Due to the individual nature of packaging the product, one non conformance in the field does not indicate additional non conformances in the additional non conformances in the field.Additionally, there have been no other complaints filed for this lot.Therefore, there is no evidence to suggest that nonconforming product are in the field.A review of relevant manufacturing documents was conducted.It was concluded that the device aspect in question was functionally inspected by quality control and no notable gaps in production or processing controls were noted.There is no indication that a design or process related failure mode contributed to the reported event.Sufficient inspection activities are in place to identify this failure mode prior to distribution.The device is provided with instructions for use which state, " caution: sterile if the package is unopened or undamaged.Do not use if the package is broken.¿ based on the information provided, inspection of the returned device, and the results of the investigation, cook has concluded the cause of the complaint is manufacturing related.The employees who packaged the product (and still work at cook) were made aware of the defect.Cook will continue monitoring of similar complaints and has notified the appropriate personnel of this event.Per a review of risk documentation, 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.
 
Event Description
No additional information regarding the patient and/or event has been received since the previous medwatch report was sent.
 
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Brand Name
GUARDIA¿ ACCESS EMBRYO TRANSFER CATHETER
Type of Device
MQF CATHETER, ASSISTED REPRODUCTION
Manufacturer (Section D)
COOK INC
750 daniels way
bloomington IN 47404
Manufacturer (Section G)
COOK INC
750 daniels way
bloomington IN 47404
Manufacturer Contact
jason crouch
750 daniels way
bloomington, IN 47404
8123392235
MDR Report Key17003763
MDR Text Key315955987
Report Number1820334-2023-00656
Device Sequence Number1
Product Code MQF
UDI-Device Identifier00827002347830
UDI-Public(01)00827002347830(17)250914(10)14957559
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
K173686
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility,Distributor
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 08/03/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/25/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberG34783
Device Catalogue NumberK-JETS-7019
Device Lot Number14957559
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Date Manufacturer Received07/12/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured09/14/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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