FDA Adverse Event Malfunction Summary report: N

MINICAP PD TRANSFER SET (EASY-LOCK) WITH TWIST CLAMP

MDR report key: 1230850 · Received November 17, 2008

Report

Report Number
1423500-2007-00153
Event Type
Malfunction
Date Received
November 17, 2008
Date of Event
April 18, 2007
Report Date
April 18, 2007
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
KDJ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

RESULTS INDICATE CONFIRMATION OF THE REPORTED EVENT. RENAL PRODUCT SURVEILLANCE, QUALITY ENGINEERING, AND PLANT MANUFACTURING WILL CONTINUE TO MONITOR THIS PRODUCT LINE.

Description of Event or Problem · 1

DURING THE EVALUATION OF A RETURNED TRANSFER SET, THE OCCLUDER FEET WERE FOUND TO BE BROKEN. NO PATIENT INJURY OR MEDICAL INTERVENTION WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MINICAP PD TRANSFER SET (EASY-LOCK) WITH TWIST CLAMP TRANSFER SETS KDJ BAXTER HEALTHCARE CORPORATION NA NA01

Patients

Seq Age Sex Outcome Treatment
1