BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LIPID FILTER, 1.2 MICRON

    MDR report key: 13550 · Received May 24, 1994

    Report

    Report Number
    MW1022225
    Event Type
    Malfunction
    Date Received
    May 24, 1994
    Date of Event
    May 1, 1994
    Report Date
    May 3, 1994
    Manufacturer
    CODAN MEDLON, INC.
    Product Code
    FPD
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    TUBING FILTER PROBLEM; PPN WAS LEAKING FROM LUER LOCK CONNECTION BETWEEN IV TUBING AND LIPID FILTER. JUNCTION TIGHT AND SECURE BUT LEAKING CONTINUED. FILTER CHANGED TO ANOTHER LIPID FILTER. PT CONTINUED RECEIVING PPN; TUBING NOT SAVED WHEN BAG CHANGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIPID FILTER, 1.2 MICRON LIPID FILTER FPD CODAN MEDLON, INC. 80657

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR