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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ERIKA DE REYNOSA, S.A. DE C.V. DRY ACID 132 GALLON UNIT, ASSY TO SHIP; DIALYSATE CONCENTRATE FOR HEMODIALYSIS (LIQUID OR POWDER)

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ERIKA DE REYNOSA, S.A. DE C.V. DRY ACID 132 GALLON UNIT, ASSY TO SHIP; DIALYSATE CONCENTRATE FOR HEMODIALYSIS (LIQUID OR POWDER) Back to Search Results
Catalog Number RTL160147
Medical Device Problem Code Thermal Decomposition of Device (1071)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/19/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The plant investigation is in process.A supplemental mdr will be submitted upon completion of this activity. .
 
Event or Problem Description
A user facility's biomedical technician (bmt) reported that a dry acid 132 gallon unit was not transferring, and the pump was not running.Upon follow up, the bmt said that the transfer motor showed signs of thermal decomposition as the white plastic propeller component was melted and fused to the outer housing.The bmt reported that there was no burning smell, smoke, spark, flame, or arcing observed.The bmt reported that there was no damage observed on any other components.The bmt said that he replaced the propeller on the transfer motor to resolve the issue.The mixer has been returned to service.A patient was not connected to the machine at the time of the incident and there was no harm to any patients or individuals because of this malfunction.The complaint sample is not available to be returned to the manufacturer for evaluation.
 
Additional Manufacturer Narrative
Plant investigation: no parts were returned to the manufacturer for physical evaluation and an on-site evaluation was not performed by a fresenius field service technician (fst).The manufacturer was able to determine a causal relationship between the objective evidence provided by the customer and the reported event.A records review was performed on the reported serial number.An investigation of the device manufacturing records was conducted by the manufacturer.There were no non-conformances, or any associated rework identified during the manufacturing process which could be related to the reported event.In addition, the device history record (dhr) review confirmed the results of the in-progress and final quality control (qc) testing met all requirements.The reported event has been confirmed.
 
Event or Problem Description
A user facility's biomedical technician (bmt) reported that a dry acid 132 gallon unit was not transferring, and the pump was not running.Upon follow up, the bmt said that the transfer motor showed signs of thermal decomposition as the white plastic propeller component was melted and fused to the outer housing.The bmt reported that there was no burning smell, smoke, spark, flame, or arcing observed.The bmt reported that there was no damage observed on any other components.The bmt said that he replaced the propeller on the transfer motor to resolve the issue.The mixer has been returned to service.A patient was not connected to the machine at the time of the incident and there was no harm to any patients or individuals because of this malfunction.The complaint sample is not available to be returned to the manufacturer for evaluation.
 
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Brand Name
DRY ACID 132 GALLON UNIT, ASSY TO SHIP
Common Device Name
DIALYSATE CONCENTRATE FOR HEMODIALYSIS (LIQUID OR POWDER)
Manufacturer (Section D)
ERIKA DE REYNOSA, S.A. DE C.V.
mike allen #1331
parque industrial reynosa
reynosa 88780
MX  88780
Manufacturer (Section G)
ERIKA DE REYNOSA, S.A. DE C.V.
director, quality systems
900 w zaragosa drive suite d
pharr TX 78577
Manufacturer Contact
jessica trujillo
920 winter st
waltham, MA 02451
6174175172
MDR Report Key24269123
Report Number0008030665-2026-00236
Device Sequence Number10021217
Product Code KPO
UDI-Device Identifier00840861100996
UDI-Public00840861100996
Combination Product (Y/N)N
Initial Reporter StateWA
Initial Reporter CountryUS
PMA/510(K) Number
K131611
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source User Facility,Company Representative
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial,Followup
Report Date (Section B) 06/24/2026
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 NumberRTL160147
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Device AgeMO
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/19/2026
Supplement Date Received by Manufacturer06/24/2026
Initial Report FDA Received Date02/05/2026
Supplement Report FDA Received Date06/24/2026
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured09/09/2015
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 Reuse
Patient Sequence Number1
Patient SexUnknown
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