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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 MZ9281
Medical Device Problem Code Crack (1135)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/03/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the bd maxzero extension set was damaged.The following information was provided by the initial reporter: our pediatric units recently implemented mz9281, and we have now received 5 reports of the luer collar cracking.All were lot 25085808.Please mention the affected number of patients with respect to the event dates.4 describe any patient¿s harm, injury, complication or negative outcome that occurred as a result of the event.Chemotherapy exposure.
 
Additional Manufacturer Narrative
B.3.The date of event is unknown; bd awareness date used.H.3.If a device evaluation and/or device history review is completed, a supplemental report will be filed.
 
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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.
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 Key25305857
Report Number9616066-2026-01387
Device Sequence Number15779681
Product Code FPA
UDI-Device Identifier10885403230646
UDI-Public(01)10885403230646(17)280826(10)25085808
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 Other,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 05/11/2026
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 NumberMZ9281
Device Lot Number25085808
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/05/2026
Initial Report FDA Received Date05/27/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/27/2025
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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