FDA Adverse Event Malfunction Summary report: N

GFS PLUS CAPILLARY DIALYZER

MDR report key: 1051424 · Received May 20, 2008

Report

Report Number
9611369-2008-00351
Event Type
Malfunction
Date Received
May 20, 2008
Date of Event
April 17, 2008
Report Date
April 21, 2008
Manufacturer
GAMBRO DIALYSATOREN GMBH
Product Code
FJI
PMA / PMN Number
K892523
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL MANUFACTURER NARRATIVE: INTERNAL BLOOD LEAKS CAN OCCUR DUE TO DAMAGE OF THE HOLLOW FIBRES. NO SAMPLE IS AVAILABLE FOR INVESTIGATION. NO FURTHER INFO IS EXPECTED FOR THIS SPECIFIC EVENT AND THE CASE IS CONSIDERED CLOSED. THE ROOT CAUSE OF THIS EVENT CANNOT BE DETERMINED. GAMBRO DOES NOT REGARD THE SUBMISSION OF THIS REPORT AS AN ADMISSION OF LIABILITY.

Description of Event or Problem · 1

THE CUSTOMER COMPLAINS ABOUT BLOOD LEAK DURING TREATMENT. THERE WAS INSIGNIFICANT BLOOD LOSS. NO MEDICAL INTERVENTION WAS NEEDED. NO SERIOUS INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GFS PLUS CAPILLARY DIALYZER FJI GAMBRO DIALYSATOREN GMBH GFS PLUS 12 7-2119-H-01

Patients

Seq Age Sex Outcome Treatment
1 NA Other