Class 2 Device Recall Percutaneous Neonatal Pigtail Nephrostomy Set and Pediatric Nephrostomy Stent Set

• Date Initiated by Firm: August 31, 2020
• Create Date: October 14, 2020
• Recall Status: Terminated on July 01, 2021
• Recall Number: Z-0106-2021
• Recall Event ID: 86411
• 510(K)Number: K181735
• Product Classification: Catheter, nephrostomy - Product Code LJE
• Product: Pediatric Nephrostomy Stent Set, Reference Part Numbers 080208-S6 and 080208-S7, Order Numbers G15034 and G15035. The set contains a radiopaque pigtail catheter and stent, retention disc with pull tie, and a 10 French, 30 cm polyvinylchloride connecting tube with one-way stopcock.
• Code Information: All lots
• Recalling Firm/ Manufacturer: Cook Inc.; 750 N Daniels Way; Bloomington IN 47404-9120
• For Additional Information Contact: Cook Medical Customer Relations Department; 812-339-2235
• Manufacturer Reason for Recall: The indwell time for the Percutaneous Neonatal Pigtail Nephrostomy Set and Pediatric Nephrostomy Stent Set is decreasing from 4 months to 4 weeks. The current IFU is in process of being updated and will be provided with orders placed following implementation.
• FDA Determined Cause: No Marketing Application
• Action: URGENT: MEDICAL DEVICE CORRECTION notification letters dated 8/31/20 were sent to customers. Actions to be Taken by the Customer 1. If affected products have already been placed within a patient, the indwell time should not exceed 4 weeks. If the current indwell time has exceeded 4 weeks, consider removing and/or replacing the product. 2. Understand that if an affected product is placed within a patient longer than 4 weeks, there is an increased potential for breakage, kinking, encrustation, migration, and/or infection to occur. 3. Please maintain a copy of this notice with the current IFU or product(s) in your inventory. 4. If you have affected product in inventory, you may continue to use these products. Cook Medical is not requesting product be returned. 5. Please complete the Acknowledgement and Receipt Form within 5 business days of receiving this letter. Even if you do not have affected product(s) on hand, you must still complete the Acknowledgement and Receipt Form and return via fax (812.339.7316) or email (FieldActionsNA@CookMedical.com). 6. This notice must be shared with appropriate personnel, including down to the user level, within your organization or with any organization where the potentially affected devices have been transferred. 7. Immediately report adverse events to Cook Medical Customer Relations by phone at 800.457.4500 or 812.339.2235, Monday through Friday between 7:30am and 5:00pm (Eastern Time), or by email to: CustomerRelationsNA@CookMedical.com. Action being Taken by Cook Medical Cook Medical is initiating a voluntary correction to inform customers that the indicated indwell time is changing for the Percutaneous Neonatal Pigtail Nephrostomy Set and Pediatric Nephrostomy Stent Set. The current IFU is in process of being updated and will be provided with orders placed following implementation. We recognize that this situation is a potential disruption to your normal operations, and we sincerely apologize. Thank you for your
• Quantity in Commerce: 380
• Distribution: Worldwide distribution - US Nationwide.
• 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.

• 510(K) Database: 510(K)s with Product Code = LJE and Original Applicant = Cook Incorporated