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U.S. Department of Health and Human Services

Class 1 Device Recall Central Venous Tray, Triple Lumen Polyurethane

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 Class 1 Device Recall Central Venous Tray, Triple Lumen Polyurethanesee related information
Date Initiated by FirmOctober 04, 2010
Date PostedFebruary 23, 2011
Recall Status1 Terminated 3 on June 21, 2011
Recall NumberZ-1188-2011
Recall Event ID 57663
510(K)NumberK072625 
Product Classification Peripherally Inserted, Central Venous Catheter Tray - Product Code LJS
ProductTurbo-Ject PICC Tray, Power Injectable, Polyurethane Peripherally Inserted Central Venous Catheter, 4.0 Fr/ 60 cm, UPICDSY-4.0-CT, G49180, Sterile, Cook Medical, Cook Incorporated, Bloomington, IN.
Code Information Part number: C-UPICDSY-4.0-CT   Global part number G49180   Lot numbers: 2308697, 2308699, 2308705 and 2309323.
Recalling Firm/
Manufacturer
Cook, Inc.
750 Daniels Way
Bloomington IN 47404-9120
For Additional Information ContactRita A. Harden
812-339-2235
Manufacturer Reason
for Recall
Cook, Inc. is recalling Single, Double, Triple, and Five-Lumen Central Venous Catheter Trays AND Single and Double Lumen PICC Peripherally Inserted Central Venous Catheter Trays. These kits and trays contain 0.9% Sodium Chloride Injection USP 5 mL fill in 6 mL flush syringes that have been recalled by Excelsior Medical. During a routine test for syringe sterility, a possible integrity failure wa
FDA Determined
Cause 2
Nonconforming Material/Component
ActionCook, Inc. sent URGENT DEVICE RECALLS letters to its customers dated 10/4/2010. The letters asked customers to examine their inventory and notify Cook for product return. The letter included a response form.
Quantity in Commerce51,473 total kits/trays
DistributionWorldwide distribution: USA, Chile, Colombia, Panama, Barbados, Canada, Guatemala, and Saudi Arabia.
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 = LJS
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