MAUDE Adverse Event Report: MERIT MEDICAL SYSTEMS, INC. BASIXCOMPAK¿; ANGIOGRAPHIC INJECTOR AND SYRINGE

Catalog Number	IN4352/K
Medical Device Problem Codes	Material Separation (1562); Detachment of Device or Device Component (2907)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	07/01/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The suspect device was not returned for evaluation.The complaint could not be confirmed.The root cause could not be established.A search of the complaint database was performed and no similar complaints for this lot number were found.The device history record was reviewed, and no exception documents were found.
Event or Problem Description
Our angiography department has encountered a problem with the merit inflator reference in4352 i3129671 (issue on 07/01/2025).The inflator handle ended up in the nurse's hand.No patient details or injury was reported.
Event or Problem Description
Follow up information: received in a meeting on 15oct2025: france team confirmed the inflator handle ended up in the nurse's hand.Handle fell off / separation of the handle and the body into two parts.Item was not used on patient as it occurred before the use while preparing the syringe to load the contrast medium and nacl mixture.
Additional Manufacturer Narrative
The suspect device was returned for evaluation.On visual inspection, the trigger handle was detached from the barrel.Additionally, adhesive residue was found in an incorrect location.This complaint has been confirmed.The root cause is incorrect adhesive placement during assembly.A search of the complaint database was performed and no similar complaints for this lot number were found.The device history record was reviewed, and no exception documents were found.

• Brand Name: BASIXCOMPAK¿
• Common Device Name: ANGIOGRAPHIC INJECTOR AND SYRINGE
• Manufacturer (Section D): MERIT MEDICAL SYSTEMS, INC.; calle, sor juana ines de la cr; roberto de la madrid; tijuana, b.c. 22630 ; MX 22630
• Manufacturer (Section G): MERIT MEDICAL SYSTEMS, INC.; calle, sor juana ines de la cr; roberto de la madrid; tijuana, b.c. 22630 ; MX 22630
• Manufacturer Contact: adrian cole ; 1600 merit parkway; south jordan
• MDR Report Key: 22952877
• Report Number: 1721504-2025-00331
• Device Sequence Number: 9515254
• Product Code: PTM
• UDI-Device Identifier: 00884450638347
• UDI-Public: 00884450638347
• Combination Product (Y/N): N
• Initial Reporter Country: FR
• PMA/510(K) Number: EXEMPT
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 10/22/2025

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Operator of Device: Health Professional
• Device Catalogue Number: IN4352/K
• Device Lot Number: I3129671
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/27/2025
• Supplement Date Received by Manufacturer: 10/03/2025
• Initial Report FDA Received Date: 09/03/2025
• Supplement Report FDA Received Date: 10/22/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 01/15/2025
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown