MAUDE Adverse Event Report: TERUMO BCT RIKA; RIKA PLASMA DONATION SYSTEM

Model Number	42000
Medical Device Problem Codes	No Apparent Adverse Event (3189); Insufficient Device Problem Information (3190)
Health Effect - Clinical Codes	Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	09/16/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Investigation: the device was checked out by a technician at the customer site.The technician did troubleshooting for alarm 3205- no fault detected in device (rollers spin freely, no obstruction, solid and responsive electrical connections).While troubleshooting the technician noticed the ac pump fluid detector was indicating the presence of air with a fluid filled tube.The tech tested ac fluid sensor with fluid filled tube: sensor detected fluid successfully.Autotests for the ac pump cca and multifunction cca protocol passed.A fluid test was also successfully completed.Investigation is in process, a follow-up report will be provided.
Event or Problem Description
The customer alleged potential for serious injury, but did not provide additional details for this event.Patient information and outcome are unknown at this time.
Additional Manufacturer Narrative
This report is being filed to provide additional information in h.6 and h.11.Investigation: the the device was checked out by a technician at the customer site.The technician did troubleshooting for alarm 3205- no fault detected in device (rollers spin freely, no obstruction, solid and responsive electrical connections).While troubleshooting the technician noticed the ac pump fluid detector was indicating the presence of air with a fluid filled tube.The tech tested ac fluid sensor with fluid filled tube: sensor detected fluid successfully.Autotests for the ac pump cca and multifunction cca protocol passed.A fluid test was also successfully completed.Further evaluation of this event has determined that the device did not cause or contribute to a death or serious injury, nor is there a likely potential for death or serious injury associated with this event based on additional investigational information.It was confirmed that the customer rationale provided did not allege medical intervention or potential harm to the donor.No further reporting will be provided as this does not represent a reportable event.
Event or Problem Description
The customer alleged potential for serious injury, but did not provide additional details for this event.Patient information and outcome are unknown at this time.

• Brand Name: RIKA
• Common Device Name: RIKA PLASMA DONATION SYSTEM
• Manufacturer (Section D): TERUMO BCT; lakewood CO 80215
• Manufacturer (Section G): TERUMO BCT; 10810 w. collins ave; lakewood CO 80215
• Manufacturer Contact: scot hilden ; 10810 w. collins ave; lakewood, CO 80215
• MDR Report Key: 23256164
• Report Number: 1722028-2025-00225
• Device Sequence Number: 10236463
• Product Code: GKT
• UDI-Device Identifier: 05020583420007
• UDI-Public: 05020583420007
• Combination Product (Y/N): N
• Initial Reporter State: FL
• Initial Reporter Country: US
• PMA/510(K) Number: BK231035
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date (Section B): 10/09/2025

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 Model Number: 42000
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 09/15/2025
• Supplement Date Received by Manufacturer: 12/17/2025
• Initial Report FDA Received Date: 10/09/2025
• Supplement Report FDA Received Date: 12/17/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 03/11/2024
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Other
• Patient Sex: Unknown