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U.S. Department of Health and Human Services

Class 2 Device Recall GEM COUPLER FORCEPS

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 Class 2 Device Recall GEM COUPLER FORCEPSsee related information
Date Initiated by FirmNovember 02, 2018
Create DateDecember 22, 2018
Recall Status1 Open3, Classified
Recall NumberZ-0680-2019
Recall Event ID 81581
Product Classification Forceps - Product Code HTD
ProductGEM Coupler Forceps, GEM4183C, packaged individually.
Code Information Product Code 5193-06001-010, Lot Number: SP18E129-1307852, Sub-lot Number: 90828, UDI: 00844735002850
FEI Number 1417572
Recalling Firm/
Manufacturer
Baxter Healthcare Corporation
1 Baxter Pkwy
Deerfield IL 60015-4625
For Additional Information Contact
800-422-9837
Manufacturer Reason
for Recall
Potential presence of rust on Coupler Forceps (GEM4183C).
FDA Determined
Cause 2
Process control
ActionSynovis Micro Companies Alliance (MCS), Inc. a subsidiary of Baxter International Inc., notified customers on about 11/02/2018 via "Urgent Product Recall letter sent via U.S.P.S., first class mail. Instructions included to review inventory for affected product, arrange for return of all affected product to Synovis MCA, complete and return the provided Baxter customer reply form, and notify customers if the affected product was further distributed. General questions can be directed to Synovia MCA at 800-510-3318 or 205-941-0111 Monday through Friday, between 8:00 am and 5:00 pm Central Time.
Quantity in Commerce123 devices
DistributionNationwide distribution to CA, FL, GA, KS, LA, MA, MS, NE, NJ, NV, NY, OH, PA, TX, UT, VA, WA, WV. International distribution to United Kingdom, Germany, South Africa, Japan, and Australia
Total Product Life CycleTPLC 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 The manufacturer has initiated the recall and not all products have been corrected or removed. This record will be updated as the status changes.
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