FDA Adverse Event Malfunction Summary report: N

POLYFLUX S CAPILLARY DIALYZER

MDR report key: 1002729 · Received February 27, 2008

Report

Report Number
9611369-2008-00152
Event Type
Malfunction
Date Received
February 27, 2008
Date of Event
January 29, 2008
Report Date
January 31, 2008
Manufacturer
GAMBRO DIALYSATOREN GMBH
Product Code
KDI
PMA / PMN Number
K982414
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

INTERNAL BLOOD LEAKS CAN OCCUR DUE TO DAMAGE TO THE HOLLOW FIBRES. NO FURTHER INFO IS EXPECTED FOR THIS SPECIFIC EVENT AND THE CASE IS CONSIDERED CLOSED. THE ROOT CAUSE OF THIS EVENT CANNOT BE DETERMINED.

Description of Event or Problem · 1

CUSTOMER COMPLAINS ABOUT LEAKAGE. NO PATIENT HARM AND NO MEDICAL INTERVENTION WAS NEEDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 POLYFLUX S CAPILLARY DIALYZER KDI GAMBRO DIALYSATOREN GMBH POLYFLUX 14 S 7-2534-H-01

Patients

Seq Age Sex Outcome Treatment
1 NA Other