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U.S. Department of Health and Human Services

Class 2 Device Recall Churchill Medical Systems, Inc. A VYGON Company PICC LINE TRAY Kit

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  Class 2 Device Recall Churchill Medical Systems, Inc. A VYGON Company PICC LINE TRAY Kit see related information
Date Initiated by Firm May 11, 2012
Date Posted June 13, 2012
Recall Status1 Terminated 3 on March 11, 2013
Recall Number Z-1802-2012
Recall Event ID 61945
510(K)Number K061497  
Product Classification Heparin, vascular access flush - Product Code NZW
Product Churchill Medical Systems, Inc. A VYGON Company PICC LINE TRAY Kit

Prefilled syringes included in the tray kit are used to maintain the patency of indwelling catheter lumens
Code Information Product Code AMS-9848CP-11 -- lots 10J80 and 10K62.
Recalling Firm/
Vygon Corporation
103 A Park Drive
Montgomeryville PA 18936-9613
For Additional Information Contact
610-539-9300 Ext. 110
Manufacturer Reason
for Recall
Manufacturer issued a voluntary recall on multiple lots of VY(TM)Flush Heparin Lock Flush Syringes therefore Vygon has subsequently initiated a recall on Vygon branded Heparin Lock Flush Syringes and kits containing the syringes.
FDA Determined
Cause 2
Nonconforming Material/Component
Action VYCON sent an URGENT MEDICAL DEVICE RECALL letter dated May 10, 2012, to all affected customers. The firm expanded their recall on May 25, 2012 by sending a second letter with additional lots and products. The letter identified the product, the problem, and the action to be taken by the customer. Customers were instructed to check their inventory and quarantine any affected product. Customers should contact Vycon's Customer Service Department at 1-800-473-5414 for a Return Merchandise Authorization number. Customers were instructed to enter the number on the space provided on the Recall Acknowledgment and Inventory Return Form, sign and date form and fax to Vycon at 215-672-6740. Customers should return the affected product as well as the original signed Recall Acknowledgment and Inventory Form using the instructions from Customer Service involving product pick-up. All inventory will be credited. If product was further distributed the Urgent Medical Device Recall letter should be provided to their customers. For questions regarding this recall call 215-672-6740.
Distribution Nationwide Distribution including AZ, CA, DE, FL, IL, IN, IA, KS, KY, MD, MA, MI, MN, MO, NJ, NY, OH, PA, UT, VA, WA, WV, and WI.
Total Product Life Cycle TPLC Device Report

1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
510(K) Database 510(K)s with Product Code = NZW and Original Applicant = EXCELSIOR MEDICAL CORP.