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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SISTEMAS MEDICOS ALARIS S.A DE C.V. ALARIS SMARTSITE; SET, ADMINISTRATION, INTRAVASCULAR

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SISTEMAS MEDICOS ALARIS S.A DE C.V. ALARIS SMARTSITE; SET, ADMINISTRATION, INTRAVASCULAR Back to Search Results
Catalog Number 2000E CHINA
Medical Device Problem Code Obstruction of Flow (2423)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/01/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
A 2000e china product was not available for investigation of (b)(4); however, the customer confirmed that the complaint sample was from lot 25075210.The feedback provided by the customer states that, "connected the transfusion set to the positive-pressure port, but no fluid flowed." further information provided by the customer states that there was no patient impact.The details of this feedback were forwarded to the manufacturing site for investigation, where a review of the production records for lot 25075210 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.However, previous complaints for occlusions have been related to features on the surface of the male luer of the connecting products.These features include flash or a raised edge to the tip of the male luer which have previously been shown to intermittently lead to restricted flow due to them pinching the blue piston of the smartsite and not allowing it to open.This can sometimes be resolved by disconnecting and reattaching the same luer connection which may reposition the luer against the piston and improve the flow, or alternatively by changing the connecting male luer.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 2000e china in the past 12 months.
 
Event or Problem Description
It is reported, the nurse connected the transfusion set to the positive pressure port, but no fluid flowed.
 
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Brand Name
ALARIS SMARTSITE
Common Device Name
SET, ADMINISTRATION, INTRAVASCULAR
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 Key24875422
Report Number9616066-2026-00968
Device Sequence Number10028824
Product Code FPA
UDI-Device Identifier07613203011938
UDI-Public(01)07613203011938
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K223088
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
Report Date (Section B) 04/03/2026
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 Health Professional
Device Catalogue Number2000E CHINA
Device Lot Number25075210
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 04/01/2026
Initial Report FDA Received Date04/14/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/05/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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