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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ERIKA DE REYNOSA, S.A. DE C.V. LIBERTY SELECT CYCLER ASSY(NON-VALUATED); System, Peritoneal, Automatic Delivery

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ERIKA DE REYNOSA, S.A. DE C.V. LIBERTY SELECT CYCLER ASSY(NON-VALUATED); System, Peritoneal, Automatic Delivery Back to Search Results
Catalog Number RTLR180343
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/03/2026
Type of Reportable Event Malfunction
Event or Problem Description
A peritoneal dialysis (pd) patient (pt) reported to fresenius medical care (fme) technical service (ts) on (b)(6)2026 that m31 air detected in cassette warning occurred fill 1 of 5 and the patient was connected during the incident.Fluid was seen in the pump module area and the film on the back of the cassette is loose.Mwd - watchdog timer error; alarm occurred in power fail recovery.Fluid was discovered during tx complete - step 9 remove cassette.Fluid was discovered in the pump module area and on the external of the cassette.Fluid leaked from unknown location; there were alarms/warnings prior to leak; m31 air detected in cassette occurred prior the fluid leak.Additional information was requested, however to date has not been provided.
 
Additional Manufacturer Narrative
The plant investigation is in process.A supplemental mdr will be submitted upon completion of this activity.
 
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Brand Name
LIBERTY SELECT CYCLER ASSY(NON-VALUATED)
Common Device Name
System, Peritoneal, Automatic Delivery
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
+1(617)417-5172
MDR Report Key50863488
Report Number0008030665-2026-02538
Device Sequence Number10714972
Product Code FKX
UDI-Device Identifier00840861102068
UDI-Public00840861102068
Combination Product (Y/N)N
Initial Reporter StateMS
Initial Reporter CountryUS
PMA/510(K) Number
K222318
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 09/23/2026
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 Lay User/Patient
Device Catalogue NumberRTLR180343
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Device AgeMO
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/03/2026
Initial Report FDA Received Date09/23/2026
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured07/11/2019
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
Concomitant Medical Products
and Therapy/Usage Dates
Delflex PD Fluid; Liberty Cycler Set
Patient SexUnknown
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