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U.S. Department of Health and Human Services

Class 2 Device Recall regard

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 Class 2 Device Recall regardsee related information
Date Initiated by FirmOctober 20, 2022
Date PostedNovember 23, 2022
Recall Status1 Open3, Classified
Recall NumberZ-0303-2023
Recall Event ID 91069
Product Classification Cardiovascular procedure kit - Product Code OEZ
Productregard CVPART1BUNDLE- MERCYSTANTHONY , CV01005H, Item Number 830099008; cardiac surgery convenience kit
Code Information UDI/DI 10194717114895, Lot Numbers: 92534, exp 11/13/2022; 93366, exp 2/28/2023
Recalling Firm/
Manufacturer
ROi CPS LLC
3000 E Sawyer Rd
Republic MO 65738-2758
For Additional Information Contact
417-730-3900
Manufacturer Reason
for Recall
Surgical convenience kits were distributed containing 3M surgical drapes which were subsequently recalled.
FDA Determined
Cause 2
Component change control
ActionROi CPS, LLC issued a MEDICAL DEVICE CORRECTION NOTICE on 10/20/2022 by email to its consignees. The notice explained the issue, the distribution dates, and kits specific to each consignee, and requested the following: "Actions to be taken by customers: 1. CHECK: Please review your inventory to determine if the manufacturer item numbers and lot numbers listed in the chart above are in your inventory. 2. QUARANTINE: Segregate and quarantine all affected kits in your inventory. 3. LABEL: Use the attached label template (Ro; CPS Correction INC13225-3M Recall Label Template-Avery 5960) to print warning labels to be affixed to all affected kits in your inventory. The label should be applied to each affected Kit and outer product case in a prominently visible location to end-users of the kits. The location chosen should not cover any other critical product information found on the existing product labeling. The label instructs users to remove and discard the 3M Steri-Drapes when the kit is opened for use. 4. REPLY: Complete the reply form included with this notice to indicate your actions in response to this notice. a. If you do not have inventory, please return the form indicating "0" affected inventory at your facility. b. Return the reply form to lacy.stewart@roiscs.com 5. NOTIFY: Please immediately notify any customers to whom you have distributed or forwarded product affected by this medical device correction notice. You may include a copy of this notice, the notice from 3M, and the attached label template with your customer notification. 6. REPORT: Report any adverse health consequences experienced with the 3M products to the FDA's MedWatch Adverse Event Reporting program via: Web: MedWatch website at www.fda.gov/medwatch Phone: 1-800-FDA-1088 (1-800-332-1088) Mail: MedWatch, HF-2, FDA, 5600 Fisher's Lane, Rockville, MD 20852-9787"
Quantity in Commerce108 kits
DistributionLA, MO, NC, FL
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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