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