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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN SMARTIP MED-PREP CANNULA; CANNULA, SURGICAL, GENERAL & PLASTIC SURGERY

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COVIDIEN SMARTIP MED-PREP CANNULA; CANNULA, SURGICAL, GENERAL & PLASTIC SURGERY Back to Search Results
Model Number 8881540111
Device Problems Fluid/Blood Leak (1250); Connection Problem (2900)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 06/11/2021
Event Type  malfunction  
Manufacturer Narrative
The complainant indicated that the device will not be returned for evaluation; therefore, a failure analysis is not available, and we are not able to determine the relationship between this device and the cause for this event.¿ as part of our manufacturing process, all device history records are reviewed and approved by quality, prior to release of product.¿ if additional information or the sample is received, the investigation will be reopened and responded to accordingly.
 
Event Description
The customer reported that when drawing up the drug fentanyl, in their gi center, the medication sprayed out of the sides of the needleless cannula at the connection where it was attached to the bd syringe.The customer is unsure if the issue was with the cannula or the syringe.The medication had to be wasted.Anecdotally, this has happened to several other nurses while drawing up their drugs also.There has been no patient harm.
 
Manufacturer Narrative
Samples were not received for the investigation.The device history record was reviewed and indicated that the product was released accomplishing all quality standards.Because a sample was not returned, we were unable to perform a follow up investigation to include functional and visual evaluations to confirm the reported issue and determine a root cause.Prior to a lot¿s release, the lot must be deemed acceptable by passing inspections that are based on a valid sampling plan.Inspectors routinely examine a statistical sample both physically and visually.Specifically, visual inspections are performed to evaluate the legitimacy of the lidding.Although the reported issue could not be confirmed based on the available information, a corrective and preventative action has been opened to further investigate leaking smart tip assemblies and is currently in the implementation phase.This information will be utilized for trending purposes to determine the need for corrective actions.
 
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Brand Name
SMARTIP MED-PREP CANNULA
Type of Device
CANNULA, SURGICAL, GENERAL & PLASTIC SURGERY
Manufacturer (Section D)
COVIDIEN
2010 east international speedw
deland FL 32724
MDR Report Key12253016
MDR Text Key264306444
Report Number1017768-2021-00965
Device Sequence Number1
Product Code GEA
UDI-Device Identifier30884521102754
UDI-Public30884521102754
Combination Product (y/n)N
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional,user faci
Type of Report Initial,Followup
Report Date 10/05/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/30/2021
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number8881540111
Device Catalogue Number8881540111
Device Lot Number110600
Was Device Available for Evaluation? No
Date Manufacturer Received07/26/2021
Patient Sequence Number1
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