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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SISTEMAS MEDICOS ALARIS S.A DE C.V. BD MAXPLUS POSITIVE PRESSURE CONNECTOR; INTRAVASCULAR ADMINISTRATION SET

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SISTEMAS MEDICOS ALARIS S.A DE C.V. BD MAXPLUS POSITIVE PRESSURE CONNECTOR; INTRAVASCULAR ADMINISTRATION SET Back to Search Results
Catalog Number MP1000 CHINA
Medical Device Problem Code Leak/Splash (1354)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 08/17/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the bd maxplus positive pressure connector had leakage.The following information was provided by the initial reporter, translated from chinese to english: during the flushing of the iv tubing on (b)(6), liquid leakage was found at the needleless connector, and the product was replaced.
 
Additional Manufacturer Narrative
H.3.If a device evaluation and/or device history review is completed, a supplemental report will be filed.
 
Additional Manufacturer Narrative
Investigation result: a mp1000 china product was not available for investigation; however, the customer confirmed that the complaint sample was from lot 24055784.The feedback provided by the customer states that, "during infusion tubing flushing, liquid leakage was found at the needleless connector." no further information was available to assist the investigation in this instance.The details of this feedback were forwarded to the manufacturing site for investigation, where a review of the production records for lot 24055784 did not identify any in-process testing failures or quality deviations which may have caused or contributed to a report of this nature.The root cause of the customer¿s experience could not be determined in this instance as no sample was received for investigation.Without a sample to examine it is not possible to determine whether a manufacturing defect could have caused or contributed to a report of this nature.In this instance, without the complaint sample to examine it has not been possible to conclusively link this feedback to a specific failure mode; however, a review of the customer feedback database indicates that this is a rare occurrence with a small number of similar reports against the product mp1000 china in the past 12 months.
 
Event or Problem Description
No additional information.
 
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Brand Name
BD MAXPLUS POSITIVE PRESSURE CONNECTOR
Common Device Name
INTRAVASCULAR ADMINISTRATION SET
Manufacturer (Section D)
SISTEMAS MEDICOS ALARIS S.A DE C.V.
parque sur, el realito
blvd. 2000
tijuana 22250
MX  22250
Manufacturer (Section G)
SISTEMAS MEDICOS ALARIS S.A DE C.V.
parque sur, el realito
blvd. 2000
tijuana 22250
MX   22250
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key23513635
Report Number9616066-2025-03418
Device Sequence Number9732821
Product Code FPA
UDI-Device Identifier10885403232985
UDI-Public(01)10885403232985(10)24055784
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K072542
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 11/14/2025
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 Other
Device Catalogue NumberMP1000 CHINA
Device Lot Number24055784
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/21/2025
Supplement Date Received by Manufacturer11/14/2025
Initial Report FDA Received Date11/10/2025
Supplement Report FDA Received Date11/24/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/27/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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