FDA Adverse Event Malfunction Summary report: N

DIALYSATE CONCENTRATE FOR HEMODIALYSIS (LIQUID OR POWDER)

MDR report key: 4112251 · Received September 23, 2014

Report

Report Number
1416980-2014-32902
Event Type
Malfunction
Date Received
September 23, 2014
Date of Event
August 20, 2014
Report Date
August 29, 2014
Manufacturer
BAXTER HEALTHCARE - SANTIAGO
Product Code
KPO
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
EC
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). ADDITIONAL INFORMATION: A REVIEW OF ALL BATCH RECORD DOCUMENTS WAS CONDUCTED WITH NO ISSUES NOTED DURING THE MANUFACTURING PROCESS. THERE WERE NO DEVIATIONS FROM STANDARD PROCEDURE AND NO EXCEPTIONS RELATED TO THE REPORTED CONDITION WERE NOTED. AN ACTUAL SAMPLE WAS RETURNED FOR EVALUATION. A VISUAL INSPECTION WAS PERFORMED WITH DAMAGE NOTED TO THE HANDHOLD OF THE BOTTLES. THE REPORTED ISSUE WAS IDENTIFIED DURING EVALUATION BUT THE CAUSE OF THE DAMAGE COULD NOT BE DETERMINED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A FOLLOW-UP REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative · 1

(B)(4). (B)(6). A BATCH REVIEW WILL BE PERFORMED. IF ANY RELEVANT INFORMATION IS OBTAINED THAT IS RELATED TO THE REPORTED EVENT, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A CONTAINER OF CONCENTRATE FOR HEMODIALYSIS LEAKED DUE TO DAMAGE ON THE HANDHOLD OF THE BOTTLE. THIS WAS IDENTIFIED DURING INCOMING INSPECTION BY THE REPORTING FACILITY. THERE WAS NO PATIENT INVOLVEMENT. NO ADDITIONAL INFORMATION IS AVAILABLE. THIS IS REPORT 9 OF 12.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
591658 DIALYSATE CONCENTRATE FOR HEMODIALYSIS (LIQUID OR POWDER) KPO BAXTER HEALTHCARE - SANTIAGO 14B0102

Patients

Seq Age Sex Outcome Treatment
1