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U.S. Department of Health and Human Services

Class 2 Device Recall AQUASTAT

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  Class 2 Device Recall AQUASTAT see related information
Date Initiated by Firm December 28, 2023
Date Posted February 22, 2024
Recall Status1 Open3, Classified
Recall Number Z-1174-2024
Recall Event ID 93848
510(K)Number K113555  
Product Classification Saline, vascular access flush - Product Code NGT
Product AQUABILITI AQUASTAT 0.9% Sodium Chloride Injection syringe, USP, 5mL in 12mL, REF 2T0805; and 3mL in 12mL, REF 2T0807, intermediate cartons containing 100 syringes, shipping cases containing 400 syringes, Rx, Sterile.
Code Information REF 2T0805 - Lot numbers KH04910, exp. 1/11/2024; KH04930, exp. 3/13/2024; KH04954, exp. 5/22/2024; KH04975, exp. 8/2/2024; KH04990, exp. 9/6/2024; KH05020, exp. 10/23/2024; KH05022, exp. 10/24/2024; KH05043, exp. 11/13/2024; KH05066, exp. 12/13/2024; KH05068, exp. 12/14/2024; KH05070, exp. 12/18/2024; KH05073, exp. 12/20/2024; KH05134, exp. 6/25/2025; KH05135, exp. 6/27/2025; and KH05152, exp. 10/10/2025; UDI-DI 10859809005013. REF 2T0807 - Lot numbers KH04909, exp. 1/10/2024; KH04944, exp. 4/24/2024; KH04986, exp. 8/30/2024; KH04988, exp. 9/5/2024; KH05024, exp. 10/25/2024; KH05026, exp. 10/26/2024; and KH05071, exp. 12/19/2024; UDI-DI 10859809005037.
Recalling Firm/
Manufacturer		 MRP, LLC dba Aquabiliti
5209 Linbar Dr Ste 640
Nashville TN 37211-1026
For Additional Information Contact Jay Davis
615-833-2633
Manufacturer Reason
for Recall		 The saline flush syringes may fail to meet USP criteria for stated sodium chloride content after 12 months.
FDA Determined
Cause 2		 Under Investigation by firm
Action The recalling firm issued a letter dated 12/28/2023 via email. The letter explained the reason for recall, risk to health, and actions to be taken. The actions included the consignee examine their inventory and discontinue distribution and use immediately. All products should be segregated. A Shipment Summary and Acknowledgment Form was enclosed for completion and return to indicate the consignee has read and understands the recall instructions, identified and quarantined the affected product in inventory, and that the consignee has notified their customers who were shipped the product. It goes onto list the specific lot numbers and quantity of affected product sent to the consignee and asks for the quantity of product consumed and the quantity available for return. The letter was also issued via certified mail on 1/4/2024. The firm issued a corrected letter dated 1/8/2024 to correct the table listing lot numbers on Page 2 of the letter. Those lot numbers were asterisked for ease of identification by the consignee. The lot numbers listed on the Shipment Summary and Acknowledgment Form were correct in the original letter.
Quantity in Commerce 3,080,000 syringes
Distribution US Nationwide distribution in the states CO, FL, NC, NY, OH, PA, TN, TX, and VA.
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 The manufacturer has initiated the recall and not all products have been corrected or removed. This record will be updated as the status changes.
510(K) Database 510(K)s with Product Code = NGT and Original Applicant = AM USA
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