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U.S. Department of Health and Human Services

Class 2 Device Recall NAMIC Convenience Kit

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  Class 2 Device Recall NAMIC Convenience Kit see related information
Date Initiated by Firm December 19, 2011
Date Posted January 19, 2012
Recall Status1 Terminated 3 on April 07, 2015
Recall Number Z-0821-2012
Recall Event ID 60729
Product Classification Cardiovascular procedure kit - Product Code OEZ
Product NAMIC (TM) Convenience Kit --- Legal Manufacturer Navilyst Medical, Inc, 26 Forest St, Marlborough, MA 01752 USA --- Made in USA: 10 Glen Falls Technical Park, Glen Falls, NY 12801 USA --- each unit label contains the customer name under the name of the product, and each catalog number is specific to the customer.

Product usage: For use in fluid management and/or invasive pressure monitoring systems
Code Information Sterile/Non-Sterile UPN Cat Num Lot Sterile Kit H749600183811 60018381 4163389;  Sterile Kit H749600308161 60030816 4155011;  Sterile Kit H749600339121 60033912 4167674;  Sterile Kit H7496005216131 60052161 4148470;  Sterile Kit H7496005216131 60052161 4152176;  Sterile Kit H7496005216131 60052161 4166769;  Sterile Kit H7496005216131 60052161 4168829;  Sterile Kit H7496005216131 60052161 4170180;  Sterile Kit H749601621861 60162186 4173288;  Sterile Kit H749601921911 60192191 4155123;  Sterile Kit H749602103071 60210307 4155130;  Sterile Kit H749602103071 60210307 4160686;  Sterile Kit H749606912341 60691234 4175188;  Sterile Kit H965600102351 60010235 4155678;  Sterile Kit H965600104921 60010492 4153182;  Sterile Kit H965600204051 60020405 4155226;  Sterile Kit H965600204051 60020405 4172242;  Sterile Kit H965600206451 60020645 4155233;  Sterile Kit H965600300681 60030068 4166803;  Sterile Kit H965600800511 60080051 4155288;  Sterile Kit H965600800511 60080051 4169451;  Sterile Kit H965601001351 60100135 4154699;  Sterile Kit H965601001351 60100135 4165389;  Sterile Kit H965601001351 60100135 4168350;  Sterile Kit H965601001351 60100135 4169879;  Sterile Kit H965601001351 60100135 4172683;  Sterile Kit H965601001351 60100135 4176389;  Sterile Kit H965602100141 60210014 4160703;  Sterile Kit H965602201531 60220153 4155363;  Sterile Kit H965PK050455S1 PK050455S 4177156;  Non-Sterile Kit H749650300641 65030064 4148480;  Non-Sterile Kit H749650300641 65030064 4168790;  Non-Sterile Kit H749650302721 64030272 4167954;  Non-Sterile Kit H749651106561 65110656 4169591;  Non-Sterile Kit H749651106561 65110656 4172687;  Non-Sterile Kit H749656900411 65690041 4166791;  Non-Sterile Kit H965650200691 65020069 4169026;  Non-Sterile Kit H965651949131 65194913 4157481;  Non-Sterile Kit H965651949131 65194913 4174714;  Non-Sterile Kit H9656522016141 652201614 4167686; Non-Sterile Kit H9656522016141 652201614 4170421;
Recalling Firm/
Manufacturer		 Navilyst Medical, Inc
10 Glens Falls Technical Park
Glens Falls NY 12801
For Additional Information Contact Michael Duerr
518-742-4571
Manufacturer Reason
for Recall		 Navilyst Medical has received reports of damaged manifolds contained in certain NAMIC Convenience Kits which may result in air injection during certain procedures.
FDA Determined
Cause 2		 Nonconforming Material/Component
Action Navilyst Medical sent an Urgent Medical Device Recall- Immediate Action Required letter dated December 19, 2011 and a Reply Verification Tracking Form to all affected consignees via Federal Express or email. The letter identified the product, description of problem, and actions to be taken Customers were instructed to 1) IMMEDIATELY DISCONTINUE USE; 2) remove the recalled product from your inventory (whether in Labs, Central Supply, Shipping and Receiving or ANY other location); 3) segregate this product in a secure location for return to Navilyst Medical, Inc; 4) immediately forward a copy of this recall notification to all sites to which you have distributed affected product; 5) complete and return the Reply Verification Tracking Form; and 6) package and return the recalled product per the instruction provided.
Quantity in Commerce 4547
Distribution Worldwide Distribution - USA (nationwide) including the states of Connecticut, Florida, Illinois, Indiana, Kentucky, Maryland, Michigan, New Jersey, New York, Ohio, South Carolina, Wisconsin, Virginia and the country of Japan.
Total Product Life Cycle TPLC Device Report
1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
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