FDA Adverse Event Malfunction Summary report: N

CLEARLINK/CONTINU-FLO

MDR report key: 22114835 · Received May 30, 2025

Report

Report Number
1416980-2025-03120
Event Type
Malfunction
Date Received
May 30, 2025
Report Date
July 15, 2025
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FPA
UDI-DI
00085412048987
PMA / PMN Number
K203609
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: H4, H6 (UPDATE CODES), H11. H4: DEVICE MANUFACTURE DATE OF THE SUSPECTED LOT IS 1/20/2025. H11: A BATCH REVIEW WAS CONDUCTED FOR THE SUSPECTED LOT AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. THE DEVICE WAS NOT RECEIVED FOR EVALUATION; THEREFORE, A DEVICE ANALYSIS COULD NOT BE COMPLETED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 0

D4: LOT #: CUSTOMER PROVIDED A SUSPECT LOT# R25A18161. D4: EXPIRATION DATE (SUSPECT LOT): 01/19/2027. D4: UNIQUE IDENTIFIER (UDI) # (SUSPECT LOT): (B)(4). SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE BLUE SLIDE CLAMP OF A CLEARLINK SYSTEM CONTINU-FLO SOLUTION SET DISINTEGRATED IN THE SLIDE CLAMP SLOT OF A NOVUM IQ LARGE VOLUME PUMP. THIS OCCURRED DURING USE ON THE PEDIATRIC UNIT; HOWEVER, PATIENT INVOLVEMENT WAS NOT SPECIFIED. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
13585 CLEARLINK/CONTINU-FLO SET, ADMINISTRATION, INTRAVASCULAR FPA BAXTER HEALTHCARE CORPORATION 2C8546 ASKU 00085412048987

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown NOVUM IQ LVP