MAUDE Adverse Event Report: CIRCULATORY TECHNOLOGY, INC. THE BETTER BLADDER

Model Number BB14

Device Problem Device Dislodged or Dislocated (2923)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Type  malfunction  

Manufacturer Narrative

All better bladder units are visually inspected and tested during manufacturing prior to release.Testing includes a pull test and leak testing to verify a hermetic seal.The units met all acceptance criteria.Evaluation of retain samples confirmed the product complaint.The units were found to have insufficient adhesive applied during the assembly resulting in an ineffective seal between the pigtail and the housing port.At the time of this report, this issue has been detected in two manufacturing lots, lot 5290-201001 and 5290-210401.Both lots have been recalled.Root cause: insufficient adhesive.Correction/containment: recall and replace.Corrective actions: an additional step is being incorporated into the assembly of the bb14 and bbb38.Henceforth, additional adhesive will be applied to the external juncture between the pigtail and the housing port, the adhesive to cover at least 1/8" along the entire periphery of the external wall of housing and at least 1/8" along the entire periphery of the od of the pigtail.This enhancement would assure more adhesive, a post assembly visual observation of the adhesive and the additional sealing that has proved effective for the seal between the large tube and the housing, a seal that has that bead.Preventive actions: add pull gage with force requirement to the process specification.Add an in-process and finished product visual inspection of the glue bead around the pigtail.

Event Description

On 4/19/2021, cti was notified by the ecmo coordinator that during an ecmo case the pigtail dislodged from the housing of a bb14.The failed bb14 was immediately replaced and no patient injury was reported.The product was identified as lot # 5290-201001.

• Brand Name: THE BETTER BLADDER
• Type of Device: BETTER BLADDER
• Manufacturer (Section D): CIRCULATORY TECHNOLOGY, INC.; 21 singworh st; oyster bay NY 11771
• Manufacturer (Section G): CIRCULATORY TECHNOLOGY, INC.; 21 singworth st.; oyster bay NY 11771
• Manufacturer Contact: ayanna brown ; 21 singworth st; oyster bay, NY 11771 ; 4077580559
• MDR Report Key: 11852675
• MDR Text Key: 263499509
• Report Number: 1000522036-2021-00002
• Device Sequence Number: 1
• Product Code: DTN
• UDI-Device Identifier: 00851997007004
• UDI-Public: (01)00851997007004(10)5290-201001(17)20231021(11)20201021
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K981284
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: health professional,user faci
• Reporter Occupation: Nurse Practitioner
• Remedial Action: Recall
• Type of Report: Initial

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 05/19/2021
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Expiration Date: 10/21/2023
• Device Model Number: BB14
• Device Catalogue Number: BB14
• Device Lot Number: 5290-201001
• Was Device Available for Evaluation?: No
• Date Manufacturer Received: 04/19/2021
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Date Device Manufactured: 10/21/2020
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Patient Outcome(s): Other
• Patient Age: 30 DA