BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CA-HP DIALYZER (CA-HP 170)

    MDR report key: 292904 · Received August 24, 2000

    Report

    Report Number
    1423500-2000-00879
    Event Type
    Malfunction
    Date Received
    August 24, 2000
    Date of Event
    August 19, 2000
    Report Date
    August 21, 2000
    Manufacturer
    NISSHO CORP
    Product Code
    FJI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SD, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    HEALTH CARE PROFESSIONAL (HCP) REPORTS ONE INCIDENT OF A BLOOD LEAK ON REUSE NUMBER 3. THIS WAS NOTED AT THE ONSET OF TREATMENT BY VISIBLE BLOOD IN THE DIALYSATE COMPARTMENT, BLOOD LEAK ALARM AND CONFIRMED WITH HEMASTIX. TREATMENT WAS CONTINUED WITH A NEW DIALYZER AND BLOODLINES WITHOUT INCIDENT. ESTIMATED BLOOD LOSS WAS 150CC. NO PT INJURY OR MEDICAL INTERVENTION REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CA-HP DIALYZER (CA-HP 170) HOLLOW FIBER DIALYZER FJI NISSHO CORP CA-HP 170 D99K25

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN RENATRON II.