FDA Adverse Event Injury Summary report: N

9616240-2008-00038

MDR report key: 1080686 · Received July 11, 2008

Report

Report Number
9616240-2008-00038
Event Type
Injury
Date Received
July 11, 2008
Product Code
FII
PMA / PMN Number
K001156
Report Source
Manufacturer report

Narratives

Additional Manufacturer Narrative · 1

ACCORDING TO THE CLINIC, THE MACHINE HAD RECEIVED A PREVENTIVE MAINTENANCE OVER THIRTEEN MOS PRIOR TO THE EVENT. THE HOSPITAL HAS SIXTY-SIX PHOENIX MACHINES LOCATED IN THREE AFFILIATED UNITS. ALL OF THE MACHINES HAVE BEEN INSPECTED BY THE LOCAL TECHNICIAN IN ORDER TO VERIFY THAT THE CONCENTRATE LINES WERE SECURELY ATTACHED TO THE CONCENTRATE CONNECTORS. THREE MACHINES PRESENTED WITH PLASTIC "TIE-WRAP" RATHER THAN A METAL CLIP SECURING THE TUBING ONTO ONE OF THE MALE CONNECTOR ASSEMBLIES. REPLACEMENT METAL CLIPS HAVE BEEN ORDERED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FII

Patients

Seq Age Sex Outcome Treatment
1