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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 MAXZERO EXTENSION SET; INTRAVASCULAR ADMINISTRATION SET

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SISTEMAS MEDICOS ALARIS S.A. DE C.V. BD MAXZERO EXTENSION SET; INTRAVASCULAR ADMINISTRATION SET Back to Search Results
Catalog Number MZ9277
Medical Device Problem Codes Complete Blockage (1094); Leak/Splash (1354)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/26/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
No product or photo was returned by the customer.The customer complaint of flow issues - fluid blockage could not be verified due to the product not being returned for failure investigation.A device history record review for material# mz9277 and lot# 25045437 was performed.The search showed that a total of (b)(4) units in 1 lot number was built on 16apr2025.There were no quality notifications issued for the failure mode reported by the customer during the production build of this set.A device history record review for material# mz9277 and lot# 25105377 was performed.The search showed that a total of 7,201 units in 1 lot number was built on 09oct2025.There were no quality notifications issued for the failure mode reported by the customer during the production build of this set.Due to no sample being received, an investigation could not be performed, and a root cause could not be determined.
 
Event or Problem Description
It was reported that bd maxzero extension set was occluded the following information was received by the initial reporter with the following verbatim this is in response to a conversation xx set up with boston mass in which that xx contract stated they believe bd has a solvent issue, of the solvent being used in excess and causing the clave to leak and or not being able to be flushed.
 
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Brand Name
BD MAXZERO EXTENSION SET
Common Device Name
INTRAVASCULAR ADMINISTRATION SET
Manufacturer (Section D)
SISTEMAS MEDICOS ALARIS S.A. DE C.V.
blvd. insurgentes no. 20351
parque industrial el florido
tijuana
Manufacturer (Section G)
SISTEMAS MEDICOS ALARIS, S.A. DE C.V.
blvd. insurgentes no. 20351
parque industrial el florido
tijuana
Manufacturer Contact
helen cox (mdr)
75 north fairway drive
vernon hills, IL 60061
8473935694
MDR Report Key24081513
Report Number9616066-2026-00024
Device Sequence Number18587828
Product Code FPA
UDI-Device Identifier10885403240799
UDI-Public(01)10885403240799(17)280415(10)25045437
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
K140831
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 01/08/2026
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 NumberMZ9277
Device Lot Number25105377
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 12/26/2025
Initial Report FDA Received Date01/15/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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