FDA Adverse Event
Malfunction
Summary report: N
DIAPACT CRRT MONITOR US
MDR report key: 3450163
·
Received September 26, 2013
Report
- Report Number
- 2523676-2013-00277
- Event Type
- Malfunction
- Date Received
- September 26, 2013
- Date of Event
- August 30, 2013
- Report Date
- August 30, 2013
- Manufacturer
- B. BRAUN MEDICAL, INC.
- Product Code
- KDI
- Product Problem
- Yes
- Report Source
- Distributor report
- Reporter Location
- GA, US
- Reporter Occupation
- BIOMEDICAL ENGINEER
Narratives
Description of Event or Problem · 1
AS REPORTED BY THE USER FACILITY: DOCTOR CLAIMS THAT BOTH DIAPACT MACHINES AT FACILITY HAVE CAUSED HEMOLYSIS ON A SINGLE PT BECAUSE THE ULTRAFILTRATION BAG IS FILLED WITH DARK FLUID. DOCTOR WANTS BOTH DIAPACT MACHINES FUNCTION CHECKED BY B. BRAUN CUSTOMER ENGINEER TO CONFIRM PROPER OPERATION. ADD'L INFO RECEIVED BY E-MAIL. PT RECEIVED PEX (PLASMA EXCHANGE) THERAPY. ASAHI PLASMA FILTER WAS USED. ICU PT. MFR REF # 3002879653-2013-00277.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 488026 | DIAPACT CRRT MONITOR US | HEMODIALYSIS SYSTEM | KDI | B. BRAUN MEDICAL, INC. | NA | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK |