| Brand Name | BD MaxZero Needleless Connector |
| 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
|
|
+1(847)393-5694
|
|
| MDR Report Key | 50595924 |
| Report Number | 9616066-2026-02223 |
| Device Sequence Number | 15849668 |
| Product Code |
FPA
|
| UDI-Device Identifier | 10885403230196 |
| UDI-Public | (01)10885403230196 |
| Combination Product (Y/N) | N |
| Initial Reporter State | OH |
| Initial Reporter Country | US |
| PMA/510(K) Number | K132413 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Other,User Facility |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
09/07/2026 |
| 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 Number | MZ1000-07 |
| Device Lot Number | Unknown |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | Not provided |
| Supplement Date Received by Manufacturer | 09/07/2026
|
| Initial Report FDA Received Date | 09/03/2026 |
| Supplement Report FDA Received Date | 09/08/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|