Z-0071-04

PeriVac brand Pericardial Fluid Aspiration Procedure Kit (Pericardiocentensis Kit), with Pigtail Drainage...

Name: Z-0071-04 PeriVac brand Pericardial Fluid Aspiration Procedure Kit (Pericardiocentensis Kit), with Pigtail Drainage...
Creator: Boston Scientific
Published: 2003-09-29
License: https://open.fda.gov/license/

Boston Scientific Corporation / initiated 2003-09-29 / Terminated

FDA source

Boston Scientific began a recall of PeriVac brand Pericardial Fluid Aspiration Procedure Kit (Pericardiocentensis Kit), with Pigtail Drainage Catheter; Model/Catalog Numbers: 4304 and 4305 on 2003-09-29. The reason FDA records is "The product has the potential to break during withdrawal process". As of 2026-09-10, the recall status on record is Terminated.

Recall record

Recall number: Z-0071-04
Status: Terminated
Initiated: 2003-09-29
Posted: 2003-10-30
Terminated: 2004-03-09
Recalling firm: Boston Scientific Corporation
Product: PeriVac brand Pericardial Fluid Aspiration Procedure Kit (Pericardiocentensis Kit), with Pigtail Drainage Catheter; Model/Catalog Numbers: 4304 and 4305
Product code: DQX Wire, Guide, Catheter
Reason for recall: The product has the potential to break during withdrawal process.
FDA root cause: Other
Action: On 9/22/03, the firm issued letters via Federal Express to all its direct consignees, informing them of the affected devices and providing instructions on the recall.
Quantity in commerce: 11835 units
Distribution: The product was distributed worldwide to hospitals and medical supply distributors, totaling 1100 consignees. The recall was appropriately extended to the consumer/user level; i.e., the wholesalers/distributors, and hospitals which received the recalled product. The product was distributed by direct sale to the following government/military accounts: 1) Brooke Army Med Ctr., 3851 Roger Brook Dr., Fort Sam Houston, TX 78234, 210-916-3083; 2) National Naval Med Ctr., 8901 Wisconsin Ave., Bethesda, MD 20889, 301-295-6756; 3) Naval Med Center, 34800 Bob Wilson Dr. San Diego, CA 92134, 619-532-9570; 4) VA Med Center, 4500 S Lancaster Rd., Dallas, TX 75216, 214-857-1757; 5) VA Med Center, 385 Tremont Ave., East Orange, NJ 07018, 973-676-1241; 6) VA Med Center, 50 Irving St., NW, Washington, DC 20422, 202-745-8000; 7) VA Med Center, BLDG 143 ? 1970 Roanoke Blvd. Salem, VA 24153, 540-983-1051; 8) VA Med Center, 3600 30th St., BLDG ? 10, Des Moines, IA 50310, 516-266-6062; 9) VA Med Center, Highway 6th West, Iowa City, IA 52246, 319-338-0581; 10) VA Med Center, 1601 Perdido St., New Orleans, LA 70146, 504-589-5994; 11) VA Med Center, 2002 Holconbe Blvd, Houston, TX 77030, 713-791-1414; 12) VA Med Center, 1055 Clermont St., Denver, CO 80220, 303-393-2850; 13) VA Med Center, 500 Foothill Dr. Salt Lake City, UT 84148, 801-584-1243; 14) VA Med Center, 1501 San Pedro SE, albuquerque, NW 87108, 505-256-2727; 15) VA Med Center, 3350 La Jolla Village Dr. San Diego, CA 92161, 858-552-8585; 16) VA Med Center, 3801Miranda Ave., Palo Alto, CA 94304, 650-447-2560; 17) VA Med Center, 1660 S Columbian Way, Seattle, WA 98108, 206-764-2008 18) VA Med Center, 130 W Kingsbridge Rd., Bronx, NY 10468, 718-584-9000; 19) VA Med Center, 5901 E 7th St., Bld 149, Long Beach, CA 90822, 310-547-8220; 20) VA Med Center, 10535 Hospital Way, Mather, CA 95655, 916-643-5844; 21)VA Westside Medical Center, 350 E Erie St., Chico, IL 60611, 312-943-6600
Product codes and lots: Batch numbers: All units of this models; UPN numbers: M00443041, M00443051, M00443040, M00443050

Product code DQX

K032050Class IIPerivac KitBoston Scientific Corp / cleared 2003-08-08

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 2026-09-30, the FDA export date for this dataset. Page last changed 2026-09-05. View this recall on fda.gov (opens on fda.gov)