Z-2764-2017Class II

DLP Extension Line Adapters 20 in length Used to extend cardioplegia line during cardiopulmonary bypass...

Name: Z-2764-2017 DLP Extension Line Adapters 20 in length Used to extend cardioplegia line during cardiopulmonary bypass...
Creator: Medtronic Perfusion Systems
Published: 2017-06-22
License: https://open.fda.gov/license/

Medtronic Perfusion Systems / initiated 2017-06-22 / Terminated / root cause: packaging

FDA source

Medtronic Perfusion Systems began a recall of DLP Extension Line Adapters 20 in length Used to extend cardioplegia line during cardiopulmonary bypass surgery on 2017-06-22. FDA classified it as Class II and gives the reason as "Identification of small pinholes in a single packaging configuration of sterile pouches. A total of seven different products were affected". As of 2026-09-10, the recall status on record is Terminated, and MDM tags the root cause as packaging.

Recall record

Recall number: Z-2764-2017
Classification: Class II
Status: Terminated
Initiated: 2017-06-22
Posted: 2017-07-10
Terminated: 2020-07-22
Recalling firm: Medtronic Perfusion Systems
Product: DLP Extension Line Adapters 20 in length Used to extend cardioplegia line during cardiopulmonary bypass surgery
Product code: DTL Adaptor, Stopcock, Manifold, Fitting, Cardiopulmonary Bypass
Reason for recall: Identification of small pinholes in a single packaging configuration of sterile pouches. A total of seven different products were affected.
Root cause tag: packaging
FDA root cause: Packaging process control
Action: Medtronic sent an Urgent Medical Device Recall letter dated June 22, 2017, to all affected consignees, both in the US, via 2-Day UPS Mail, and OUS, via local methods. Consignees were asked to quarantine and return any affected product. No recommendations were made for patients who have undergone procedures using affected product. US consignees were asked to complete and return a recall notification confirmation certificate to fax 651-367-0612, indicating that they were informed of the recall and executed the appropriate action. Customers with questions were instructed to contact Customer Service at 1-800-854-3570. For questions regarding this recall call 763-526-2494.
Quantity in commerce: 63053 (48180 US) (14873 OUS)
Distribution: Worldwide Distribution - US (nationwide) Foreign: Argentina, Australia, Austria, Belgium, Bulgaria, Canada, Croatia, Denmark, El Salvador, France, Georgia, Germany, Hungary, Ireland, Israel, Italy, Japan, Kuwait, Lebanon, Macedonia, Moldova, Netherlands, New Zealand, Nigeria, Norway, Poland, Romania, Russian Federation, Slovenia, Spain, Thailand, Turkey, & United Kingdom.
Product codes and lots: Model No. 11001G; Product UPN 20613994918554; Lot No. 2016020769, 2016030796, 2016040778, 2016060872, 2016061425, 2016070500, 2016081190, 2016090516, 2016091016, 2016110504, 2016120414, 2017010236, 2017011281, 2017030506.

Enforcement reports

One row per recalled product line

FDA enforcement reports joined to recall event Z-2764-2017
Recall number	Class	Status	Voluntary or mandated	Report date	Classified
Z-2764-2017	Class II	Terminated	Voluntary: Firm initiated	2017-08-02	2017-07-25
Z-2765-2017	Class II	Terminated	Voluntary: Firm initiated	2017-08-02	2017-07-25
Z-2766-2017	Class II	Terminated	Voluntary: Firm initiated	2017-08-02	2017-07-25
Z-2767-2017	Class II	Terminated	Voluntary: Firm initiated	2017-08-02	2017-07-25
Z-2768-2017	Class II	Terminated	Voluntary: Firm initiated	2017-08-02	2017-07-25

Product code DTL

K790564Class IIAdapter-StraightDlp, Inc. / cleared 1979-04-12

MDM coverage of this record lists here, newest first.

About this record

Sourced from the FDA device recall database and the FDA enforcement reports, both ingested from openFDA. The recall record supplies the product, the reason and the product code; the enforcement report supplies the classification. The two datasets are exported by FDA on different days, and the date above is the older of the two, so nothing on this page is newer than it says.

MDM adds the root cause tag, derived from FDA’s own root cause text, and the cross-links to the product code, the clearances named on the record and MDM coverage. Where a recall has not been joined to an enforcement report, no classification is shown.

Data as of 2026-10-14, the FDA export date for this dataset. Page last changed 2026-09-05. View this recall on fda.gov (opens on fda.gov)