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U.S. Department of Health and Human Services

Class 2 Device Recall Cycler Drain Bag Set (item number: 02620226A)

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 Class 2 Device Recall Cycler Drain Bag Set (item number: 02620226A)see related information
Date Initiated by FirmApril 28, 2021
Create DateJuly 16, 2021
Recall Status1 Terminated 3 on August 08, 2022
Recall NumberZ-2083-2021
Recall Event ID 87998
510(K)NumberK173363 
Product Classification Set, administration, for peritoneal dialysis, disposable - Product Code KDJ
ProductThe Drain Bag Set (tubings and flexible bags) is a passive, closed drainage system used as an optional receptacle during an APD treatment. The Drain Bag Set is used to collect effluent in bags rather than letting the effluent flow directly to a drain. The Drain Bag Set connects to the drain line of a cycler set to collect patient effluent by means of gravity and the pumping action of a Peritoneal Dialysis (PD) cycler. The Drain Bag Set connects to the drain line using a standard Luer lock connection. The Drain Bag Set consists of three (3) interconnected 7-liter drain bags, each with a sampling port and an occluding clamp. The tubing lines that connect each drain bag to the drain line have a snap-disconnect tubing segment. This tubing segment allows the user to disconnect individual bags by snapping the tubing apart.
Code Information Lot Number: 20NR08163 UDI: (01)00840861102037
Recalling Firm/
Manufacturer
Fresenius Medical Care Holdings, Inc.
920 Winter St Bld 950
Waltham MA 02451-1521
For Additional Information ContactFresenius Medical Care Customer Service
800-323-5188
Manufacturer Reason
for Recall
Exposed to freezing temperatures due to refrigerated truck malfunctions
FDA Determined
Cause 2
Environmental control
ActionFresenius issued telephone script communication on April 28.2021 stating reason for recall, heath risk and action to take: Tell them you already contacted their Home Therapy Nurse to alert them that you would be calling them. o The purpose of my call today is that you received a delivery from us on (either Feb 22nd or Feb 23rd). o The truck you received a delivery from had a temperature malfunction due to the bad storms Texas experienced back in February. This caused the product you were delivered to be exposed to freezing or near freezing temperatures for about 3 hours. o o I see you received on . o (if received any PD SOLUTION/SALINE/or CONCENTRATES): Explain that the solutions inside their product are not affected and that we have freeze/thaw studies that prove this. Explain that due to the freezing temperatures, the packaging may become compromised, and they may have seen leaks. For the other products such as Hand Sanitizer and other ancillary products, again, the product could be compromised according to their packaging requirements listed on their packaging. o We are giving you the opportunity to return these products if you choose to do so at this time. o If returning product(s): o Fill out RGA spreadsheet with customer information including how much product they are returning (include lot# and amount returning). Driver will pick up returned products on their next scheduled visit. Fresenius Corrections and Removals Rep: Email Post Market Surveillance to open a complaint against product. o If not returning product(s): o Thank them for their time and reiterate to always inspect their packaging for leaks as this is what they are trained to do anyways from their Home Therapies Nurse. If you have any questions call 781-699-2243 or email: beth.st.germain@fmc-na.com
Quantity in Commerce10 cases
DistributionUS Distribution to: TX only
Total Product Life CycleTPLC 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) Database510(K)s with Product Code = KDJ
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