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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM; CATHETER, HEMODIALYSIS, IMPLA

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ARROW INTERNATIONAL LLC ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM; CATHETER, HEMODIALYSIS, IMPLA Back to Search Results
Catalog Number CS-15242-SP
Medical Device Problem Codes Crack (1135); Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/09/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that "on 09apr2026 during patient use, the luer hub/fitting was found cracked and leaking." there were no reports of patient injury, harm, or adverse health consequences associated with the event.The patient's condition was reported as fine.No medical intervention was necessary, and the procedure was completed after switching to another device.
 
Additional Manufacturer Narrative
(b)(4).
 
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Brand Name
ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM
Common Device Name
CATHETER, HEMODIALYSIS, IMPLA
Manufacturer (Section D)
ARROW INTERNATIONAL LLC
morrisville NC
Manufacturer (Section G)
ARROW INTERNATIONAL DE MEXICO S.A. DE C.V.
ave. washington 3701
colonia panamericana, chihuahua
chihuahua 31200
MX   31200
Manufacturer Contact
katharine tarpley
3015 carrington mill blvd
morrisville, NC 27560
MDR Report Key25071741
Report Number9680794-2026-00328
Device Sequence Number10747358
Product Code MSD
UDI-Device Identifier00801902096326
UDI-Public(01)00801902096326(11)240419(17)270331(10)33F23L0941(21)
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K111117
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility,Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 04/09/2026
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 NumberCS-15242-SP
Device Lot Number33F23L0941
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/09/2026
Supplement Date Received by Manufacturer06/09/2026
Initial Report FDA Received Date05/04/2026
Supplement Report FDA Received Date06/22/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/19/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
NOT REPORTED
Patient SexUnknown
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