FDA Adverse Event
Malfunction
Summary report: N
IVENIX, INC.
MDR report key: 23058355
·
Received September 15, 2025
Report
- Report Number
- 3014732157-2025-01000
- Event Type
- Malfunction
- Date Received
- September 15, 2025
- Date of Event
- September 26, 2022
- Report Date
- September 15, 2025
- Manufacturer
- FRESENIUS KABI USA, LLC
- Product Code
- FPA
- UDI-DI
- 00811505030054
- PMA / PMN Number
- K183311
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NJ, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
THE FOLLOWING HAS BEEN REPORTED: THIS INCIDENT HAPPENED PRIOR TO BEGINNING TREATMENT WHEN THE TUBING WAS ALREADY INSERTED AND WATER WAS COMING OUT OF THE MACHINE. THE DOOR WAS OPENED TO CHECK IF IT WAS PROPERLY LOADED. THE TUBING WAS LOADED PROPERLY, BUT THE WATER WAS STILL COMING OUT OF THE PUMP. SO, THE NURSE HAD TO GET ANOTHER ADMINISTRATION SET. A PRELIMINARY REVIEW OF THE LOGS COULD NOT BE PERFORMED. THE DEVICE WAS RETURNED FOR EVALUATION. ADMIN SET DIAPHRAGM NOT FULLY CAPTURED BY THE ADMIN SET SHELL AND ISN'T FULLY SEALING THE FLUID FLOW PATH. FRESENIUS KABI HAS PERFORMED A RETROSPECTIVE REVIEW OF COMPLAINTS ASSOCIATED WITH THIS FAILURE MODE AND HAS DECIDED TO SUBMIT AN MDR AS A CONSERVATIVE MEASURE. NO ADVERSE EFFECTS WERE REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1398631 | IVENIX, INC. | LVP PRIMARY ADMINISTRATION SET, DUAL-INLET, LOW-SORBING, NEEDLE-FREE PORT, Y-SIT | FPA | FRESENIUS KABI USA, LLC | SET-0013-1 | 00811505030054 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown |