FDA Adverse Event Malfunction Summary report: N

DIALYZER, HIGH PERMEABILITY WITH OR WITHOUT SEALED DIALYSATE SYSTEM

MDR report key: 3953333 · Received July 23, 2014

Report

Report Number
1416980-2014-23889
Event Type
Malfunction
Date Received
July 23, 2014
Date of Event
June 30, 2014
Report Date
June 30, 2014
Manufacturer
BAXTER HEALTHCARE - CALI
Product Code
KDI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PE
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). (B)(6). EVALUATION SUMMARY: A BATCH REVIEW WAS CONDUCTED AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. VISUAL INSPECTION IDENTIFIED SMALL HOLES IN THE FOIL OVERPOUCH OF THE SAMPLE. THE CAUSE OF THE DRY IODINE WAS DETERMINED TO BE THE HOLES IN THE FOIL, WHICH ALLOWED AIR INTO THE PACKAGING. THE CAUSE OF THE HOLES IN THE FOIL WAS DETERMINED TO BE DEFECTIVE RAW MATERIAL. THE SUPPLIER OF THE FOIL WAS NOTIFIED TO ADDRESS THIS ISSUE. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

DURING EVALUATION OF A RETURNED UNUSED MINICAP PREP KIT, DRY IODINE WAS OBSERVED IN THE SPONGE OF THE MINICAP. THERE WAS NO PATIENT INVOLVEMENT. NO ADDITIONAL INFORMATION IS AVAILABLE. THIS IS REPORT 19 OF 103.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
431145 DIALYZER, HIGH PERMEABILITY WITH OR WITHOUT SEALED DIALYSATE SYSTEM KDI BAXTER HEALTHCARE - CALI SE12KD8

Patients

Seq Age Sex Outcome Treatment
1