FDA Adverse Event Malfunction Summary report: N

OPTIFLUX F250NRE DIALYZER

MDR report key: 3922201 · Received May 23, 2014

Report

Report Number
1713747-2014-00255
Event Type
Malfunction
Date Received
May 23, 2014
Date of Event
March 31, 2014
Report Date
May 9, 2014
Manufacturer
OGDEN MANUFACTURING
Product Code
KDI
PMA / PMN Number
K082414
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NO INFORMATION

Narratives

Additional Manufacturer Narrative · 1

THE PLANT INVESTIGATION HAS NOT YET BEEN COMPLETED. A F/U REPORT WILL BE FILED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

A HEMODIALYSIS INPATIENT USER FACILITY HAS REPORTED THAT DURING TREATMENT, A BLOOD LEAK OCCURRED. THE LEAK WAS VISUALLY OBSERVED AND THE MACHINE ALARMED. ESTIMATED BLOOD LOSS WAS LESS THAN 10CC'S. PT REQUIRED NO MEDICAL INTERVENTION. SAMPLE HAS NOT BEEN RETURNED TO THE MFR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
307327 OPTIFLUX F250NRE DIALYZER KDI OGDEN MANUFACTURING 14AU02001

Patients

Seq Age Sex Outcome Treatment
1 HEMODIALYSIS MACHINE