FDA Adverse Event Malfunction Summary report: N

OPTIFLUX F250NRE DIALYZER

MDR report key: 3963397 · Received June 19, 2014

Report

Report Number
1713747-2014-00311
Event Type
Malfunction
Date Received
June 19, 2014
Date of Event
May 27, 2014
Report Date
June 9, 2014
Manufacturer
FRESENIUS MEDICAL CARE NORTH AMERICA
Product Code
KDI
PMA / PMN Number
K082414
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PLANT INVESTIGATION HAS NOT YET BEEN COMPLETED. A FOLLOW UP 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. TEST STRIPS WERE USED TO CONFIRM AND THE MACHINE ALARMED. ESTIMATED BLOOD LOSS WAS 150 ML. PATIENT HAD NO ADVERSE EFFECTS AND NO MEDICAL INTERVENTION WAS REQUIRED. THE PATIENT COMPLETED TREATMENT. SAMPLE AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
360846 OPTIFLUX F250NRE DIALYZER KDI FRESENIUS MEDICAL CARE NORTH AMERICA 13NU2016

Patients

Seq Age Sex Outcome Treatment
1 73 YR FRESENIUS 2008K2 HEMODIALYSIS MACHINE