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Supplemental report 01 - (b)(4) - mdr 3003442380-2024-12504.Correction: this mdr is being submitted to correct the submitted expiration date under d4 and manufacturing date under h4.Additional information - this mdr is being submitted to include the below: h6: investigation results under type of investigation, investigation findings, investigation conclusions.H11: investigation summary.Complaint investigation results: electronic quality management system (eqms) search: a query was run in the eqms on 16-dec-2025 against "lot number [6003872] and similar malfunction codes: occlusion (e.G.Occlusion alarm from the infusion pump may have sounded).(source/cause cannot be identified, only use when a specific malfunction cannot be determined), occlusion issues-cannot be determined].The review confirmed that lot [6003872] and the identified failure mode are not associated with any ncrs or capas of the same or similar nature.Similar complaints search: a query was run in the eqms on [16-dec-2025] against "lot number" criteria equal [6003872] and similar malfunction codes: occlusion (e.G.Occlusion alarm from the infusion pump may have sounded).(source/cause cannot be identified, only use when a specific malfunction cannot be determined), occlusion issues-cannot be determined].The count of complaint is [1].The complaint number is (b)(4).Device history record (dhr) review: the lot [6003872] was manufactured according to the wi version [65] packaging in the line [inset 6] on [17/oct/2023] with a total of (b)(4) units.The sub-assembly, [gluing tube] of the lot [3k02076] was manufactured according to the wi version [56] and manufactured in the [machine sc02], on [14/oct/2023], with a total of (b)(4) units.The sub-assembly, [gluing tube] of the lot [3k02267] was manufactured according to the wi version [56] and manufactured in the [machine sc02], on [15/oct/2023], with a total of (b)(4) units.The device history record (dhr) was reviewed in accordance with applicable procedures.All required in-process and final tests were completed and met specified requirements.No deviations were identified, and no maintenance events were recorded that relate to the complaint code.Conclusion: dhr review supports compliance with manufacturing and quality requirements; no issues noted.Visual evidence review: no photo was provided to support visual confirmation of the reported issue.Conclusion: unable to perform visual verification; assessment based on available documentation only.Corrective and preventive action (capa) determination assessment - conclusion summary of complaint investigation: based on the investigation, no further investigation is required.The record will be closed and monitored through tracking and trending.Conclusion summary of complaint investigation: as a result of the following: a comprehensive review was conducted, including eqms queries, similar complaint searches, device history record review, visual evidence assessment, and capa determination.No ncrs or capas of the same or similar nature were found for lot [6003872] and related malfunction codes for [occlusion].[one] complaint was identified for this lot, but no trend or systemic issue was detected.The manufacturing records confirmed that the lot was produced in compliance with all requirements, with no deviations or maintenance events noted.No photo evidence was provided, so the assessment was based on documentation only.Based on these results, no manufacturing or quality issues were identified, and no further investigation is required.The record will be closed and monitored through routine tracking and trending.
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