Udi - not required for product code.Implanted date: device was not implanted.Explanted date: device was not explanted.Address- national hospital organization (b)(6) medical center.Occupation- clinical engineering.Pma/510(k)- k130520.The actual sample was received for evaluation.Visual inspection revealed that the lock adapter had come off the male connector of the sampling system.Magnifying inspection of the actual sample did not find any visible anomaly, including deformity, in the male connector or in the lock adapter.The outer diameter of the rib of the male connector and the inner diameter of the lock adapter were measured.Compared with a current product sample, no difference was observed in the measured values.The surface of the male connector was subjected to elemental analysis by sem-edx (scanning electron microscope / energy dispersive x-ray spectroscopy).The result showed the presence of si, which is likely to be derived from the silicone applied to the switch cocks of the three-way stopcock to improve the lubricity of them in the manufacturing process.Simulation test: silicone was applied to a male connector of a factory-retained sampling system, a female connector was connected to it, and then a lock adapter was tightened up.As a result, the lock adapter came off.A review of the device history record and product-release judgement record of the involved product code/lot# combination was conducted with no findings.Ifu states: do not use if the package or device is damaged (e.G.Cracked) or any of the port caps are off.Based on the provided information and investigation results, there is no definitive evidence that this event was related to a device defect or malfunction.It is likely that the silicon, which is applied to the switch cocks of the sampling system to improve the lubricity, was transferred to the male connector part due to some factors.Afterward, the lock adapter, when re-tightened, may have got over the rib of the male connector in lubricated state and came off.However, from the available information including the state of the actual sample, it could not be determined when silicone was transferred to the male connector.The exact cause of the reported event cannot be definitively determined based on the available information.(b)(4).
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