BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CAPD SOLUTION TRANSFER SET (SHORT) FRO UV-FLASH

    MDR report key: 833973 · Received October 17, 2006

    Report

    Report Number
    1423500-2006-01127
    Event Type
    Malfunction
    Date Received
    October 17, 2006
    Date of Event
    September 19, 2006
    Report Date
    September 19, 2006
    Manufacturer
    BAXTER HEALTHCARE CORPORATION
    Product Code
    KDJ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    BAXTER REPORTED THAT A LEAK WAS FOUND INSIDE THE CAP OF A TRANSFER SET. NO PT INJURY OR MEDICAL INTERVENTION WAS ASSOCIATED WITH THIS INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CAPD SOLUTION TRANSFER SET (SHORT) FRO UV-FLASH TRANSFER SET KDJ BAXTER HEALTHCARE CORPORATION NA NA01

    Patients

    Seq Age Sex Outcome Treatment
    1 YR