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NA BB11W05RRecalls & reported problems

Medtronic, Inc. · CUSTOM PACK BB11W05R VCH CSTM PERF · Class 2

Adverse event reports
1
Deaths reported
0
Injuries reported
0
Recalls naming it
0

Summary

The FDA's MAUDE database contains 1 adverse event report that list this exact device (DI 00763000686130), received between Oct 6, 2022 and Oct 6, 2022 — classified as 1 malfunction.

The most frequently reported specific device problem is “Fluid/Blood Leak” (1 report).

25 other recalls cover devices cleared under the same FDA submission (K171979); they may or may not involve this specific model.

Reports come from manufacturers, hospitals and patients and are not verified by the FDA. A report does not prove the device caused the event, and counts can't be used to compare devices or estimate failure rates. How this data works · Data updated Oct 13, 2026.

Most reported problems

Device problems

  • Fluid/Blood Leak1

Patient problems

  • Hemorrhage/Blood Loss/Bleeding1
  • No Clinical Signs, Symptoms or Conditions1

Recent adverse event reports

The 1 most recent of 1 reports, in the reporter's own words as published by the FDA.

  • MalfunctionOct 6, 2022Fluid/Blood Leak; Fluid/Blood Leak

    MEDTRONIC RECEIVED INFORMATION THAT DURING USE OF A CUSTOM TUBING PACK, IT WAS REPORTED THAT ONE SIDE OF THE VRV-100 ONE WAY VALVE WAS NOT SOLVENT BONDED COMPLETELY DURING THE LINE ASSEMBLY AND A SMALL LEAK OF BLOOD WAS OBSERVED AROUND THE TUBING AND THE VRV100 CONNECTION. THERE WAS NO PATIENT IMPACT ASSOCIATED WITH THIS EVENT.

    Patient problems: Hemorrhage/Blood Loss/Bleeding; No Clinical Signs, Symptoms or Conditions

    MAUDE report 15549406 ↗

Recalls under the same FDA submission

These recalls involve devices cleared under K171979. One submission often covers many models, so check the product and lot details in each record.

  • Z-1894-2021 · Apr 29, 2021 · Terminated
    Medtronic BB9G78R8, Custom Pack BB9G78R8 ECC Supp, Custom Perfusion System, Sterile, Rx.
  • Z-1874-2021 · Apr 29, 2021 · Terminated
    Medtronic BB11J14R2, Custom Pack BB11J14R2 Bridge, Custom Perfusion System, Sterile, Rx.
  • Z-1884-2021 · Apr 29, 2021 · Terminated
    Medtronic CB10W65R1, Custom Pack CB10W65R1 CH Access1/4, Custom Perfusion System, Sterile, Rx.
  • Z-1876-2021 · Apr 29, 2021 · Terminated
    Medtronic CB7J97R8, Custom Pack CB7J97R8 U14 E Sup, Custom Perfusion System, Sterile, Rx.
  • Z-1891-2021 · Apr 29, 2021 · Terminated
    Medtronic CB10Y89R10, Custom Pack CB10Y89R10 ECC 3/8 A/V, Custom Perfusion System, Sterile, Rx.
  • Z-1877-2021 · Apr 29, 2021 · Terminated
    Medtronic HY11B40R1, Custom Pack HY11B40R1 1/4 Respirato, Custom Perfusion System, Sterile, Rx.
  • Z-1880-2021 · Apr 29, 2021 · Terminated
    Medtronic HY8R62R13,Custom Pack HY8R62R13 E Pack, Custom Perfusion System, Sterile, Rx.
  • Z-1885-2021 · Apr 29, 2021 · Terminated
    Medtronic HY10Y54R4, Custom Pack HY10Y54R4 ECC PED 1/4, Custom Perfusion System, Sterile, Rx.
  • Z-1871-2021 · Apr 29, 2021 · Terminated
    Medtronic HY10Z48R2, Ctr., Custom Pack HY10Z48R2 Adult ECC 1/4, Custom Perfusion System, Sterile, Rx.
  • Z-1889-2021 · Apr 29, 2021 · Terminated
    Medtronic CB7J98R7, Custom Pack CB7J98R7, Custom Pack CB7J98R7 3/8 Pack, Custom Perfusion System, Sterile, Rx.
  • Z-1875-2021 · Apr 29, 2021 · Terminated
    Medtronic HY7M07R6, Custom Pack HY7M07R6 E 1/4, Custom Perfusion System, Sterile, Rx.
  • Z-1881-2021 · Apr 29, 2021 · Terminated
    Medtronic CB4W67R20, Custom Pack CB4W67R20 Adult E, Custom Perfusion System, Sterile, Rx.
  • Z-1890-2021 · Apr 29, 2021 · Terminated
    Medtronic HY10L28R3, Custom Pack HY10L28R3 1/4 Pack, Custom Perfusion System, Sterile, Rx.
  • Z-1882-2021 · Apr 29, 2021 · Terminated
    Medtronic CB10W64R1, Custom Pack CB10W64R1 CH Access 3/8, Custom Perfusion System, Sterile, Rx.
  • Z-1887-2021 · Apr 29, 2021 · Terminated
    Medtronic CB10R79R6, Custom Pack CB10R79R6 1/4X1/4 Loop, Custom Perfusion System, Sterile, Rx.

…and 10 more.

Other Catheter, cannula and tubing, vascular, cardiopulmonary bypass devices

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Sources: FDA GUDID, MAUDE and Medical Device Recalls via openFDA. openFDA data is not validated for clinical or regulatory use.