Medical Device
Manufacturing
THE TRADE PAPER OF THE FACTORY FLOOR
Z-0995-2016Class II

EndoVive 3s Low Profile Balloon Kits Part Number: M00548620 (XMD P/N 70-0050-D16) The EndoVive 3s Low Profile...

Xeridiem Medical Devices / initiated 2015-12-23 / Terminated / root cause: design

Xeridiem Mediem Medical Devices Inc began a recall of EndoVive 3s Low Profile Balloon Kits Part Number: M00548620 (XMD P/N 70-0050-D16) The EndoVive 3s Low Profile Balloon is intended to provide gastric access... on . FDA classified it as Class II and gives the reason as "A feeding (reflux) valve leakage issue. The feeding valve appears to close inconsistently, or close in a delayed manner, when an extension set is disconnected from the Low Profile Balloon device, thus allowing feeding...". As of , the recall status on record is Terminated, and MDM tags the root cause as design.

Recall record

Recall number
Z-0995-2016
Classification
Class II
Status
Terminated
Initiated
Posted
Terminated
Recalling firm
Xeridiem Medical Devices
Product
EndoVive 3s Low Profile Balloon Kits Part Number: M00548620 (XMD P/N 70-0050-D16) The EndoVive 3s Low Profile Balloon is intended to provide gastric access through a gastrointestinal stoma tract for enteral feeding, medication administration and gastric decompression. The EndoVive 3s Low Profile Balloon is indicated for use in adult and pediatric patients who require long-term feeding, are unable to tolerate oral feeding, are at low risk for aspiration or require gastric decompression and/or medication delivery directly into the stomach.
Product code
PIF Gastrointestinal Tubes With Enteral Specific Connectors
Reason for recall
A feeding (reflux) valve leakage issue. The feeding valve appears to close inconsistently, or close in a delayed manner, when an extension set is disconnected from the Low Profile Balloon device, thus allowing feeding solution or gastric contents to leak out of the device in some instances.
Root cause tag
design
FDA root cause
Device Design
Action
Xeridiem sent a customer notification letter dated December 23, 2015, to all affected customers. The letter identified the product, the problem, and the action to be taken by the customer. Customer was provided the following instructions: 1. Segregate all devices from the above table that in Boston Scientific Corporation's inventory and restrict them from being distributed to end users. 2. Determine the list of end users who have received devices from the above list, notify them of the quality issue, and have these devices returned to Boston Scientific Corporation. Provide Xeridiem Medical Devices with this list of end users. For any questions the customers is instructed to contact the firm. For questions regarding this recall call 520-882-7794.
Quantity in commerce
40
Distribution
Nationwide distribution to MA only.
Product codes and lots
Part Number: M00548620 (XMD P/N 70-0050-D16)  Lot Number: 929704

Enforcement reports

One row per recalled product line
FDA enforcement reports joined to recall event Z-0995-2016
Recall numberClassStatusVoluntary or mandatedReport dateClassified
Z-0912-2016Class IITerminatedVoluntary: Firm initiated
Z-0913-2016Class IITerminatedVoluntary: Firm initiated
Z-0914-2016Class IITerminatedVoluntary: Firm initiated
Z-0915-2016Class IITerminatedVoluntary: Firm initiated
Z-0916-2016Class IITerminatedVoluntary: Firm initiated
Z-0917-2016Class IITerminatedVoluntary: Firm initiated
Z-0918-2016Class IITerminatedVoluntary: Firm initiated
Z-0919-2016Class IITerminatedVoluntary: Firm initiated
Z-0920-2016Class IITerminatedVoluntary: Firm initiated
Z-0921-2016Class IITerminatedVoluntary: Firm initiated
Z-0922-2016Class IITerminatedVoluntary: Firm initiated
Z-0923-2016Class IITerminatedVoluntary: Firm initiated
Z-0924-2016Class IITerminatedVoluntary: Firm initiated
Z-0925-2016Class IITerminatedVoluntary: Firm initiated
Z-0926-2016Class IITerminatedVoluntary: Firm initiated
Z-0927-2016Class IITerminatedVoluntary: Firm initiated
Z-0928-2016Class IITerminatedVoluntary: Firm initiated
Z-0929-2016Class IITerminatedVoluntary: Firm initiated
Z-0930-2016Class IITerminatedVoluntary: Firm initiated
Z-0931-2016Class IITerminatedVoluntary: Firm initiated
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Z-0951-2016Class IITerminatedVoluntary: Firm initiated
Z-0952-2016Class IITerminatedVoluntary: Firm initiated
Z-0953-2016Class IITerminatedVoluntary: Firm initiated
Z-0954-2016Class IITerminatedVoluntary: Firm initiated
Z-0955-2016Class IITerminatedVoluntary: Firm initiated
Z-0956-2016Class IITerminatedVoluntary: Firm initiated
Z-0957-2016Class IITerminatedVoluntary: Firm initiated
Z-0958-2016Class IITerminatedVoluntary: Firm initiated
Z-0959-2016Class IITerminatedVoluntary: Firm initiated
Z-0960-2016Class IITerminatedVoluntary: Firm initiated
Z-0961-2016Class IITerminatedVoluntary: Firm initiated
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Z-0986-2016Class IITerminatedVoluntary: Firm initiated
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Z-0990-2016Class IITerminatedVoluntary: Firm initiated
Z-0991-2016Class IITerminatedVoluntary: Firm initiated
Z-0992-2016Class IITerminatedVoluntary: Firm initiated
Z-0993-2016Class IITerminatedVoluntary: Firm initiated
Z-0994-2016Class IITerminatedVoluntary: Firm initiated
Z-0995-2016Class IITerminatedVoluntary: Firm initiated
Z-0996-2016Class IITerminatedVoluntary: Firm initiated
Z-0997-2016Class IITerminatedVoluntary: Firm initiated
Z-0998-2016Class IITerminatedVoluntary: Firm initiated
Z-0999-2016Class IITerminatedVoluntary: Firm initiated
Z-1000-2016Class IITerminatedVoluntary: Firm initiated
Z-1001-2016Class IITerminatedVoluntary: Firm initiated
Z-1002-2016Class IITerminatedVoluntary: Firm initiated
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Z-1006-2016Class IITerminatedVoluntary: Firm initiated
Z-1007-2016Class IITerminatedVoluntary: Firm initiated
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Z-1009-2016Class IITerminatedVoluntary: Firm initiated
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Z-1015-2016Class IITerminatedVoluntary: Firm initiated
Z-1016-2016Class IITerminatedVoluntary: Firm initiated