inforMED
MalfunctionGKT

APHERESIS KIT

Received Apr 1, 2021 · Event occurred Mar 26, 2021

Report MW5100510 · MDR key 11607943

Device

Generic name

Separator, Automated, Blood Cell, Diagnostic

Manufacturer

Terumo Bct, Inc.

Lot number

2010093130

Product problems

  • Device Alarm System
  • Complete Blockage

Patient

63 YR

  • Insufficient Information
  • Insufficient Information

Narrative

Description of Event or Problem

PATIENT UNDERWENT AUTOLOGOUS STEM CELL COLLECTION (B)(6) 2021. AT THE END OF COLLECTION, PRODUCT WAS NOTED TO BE CLOTTED AND UNSUITABLE FOR USE. AS A RESULT, THE PRODUCT WAS DISCARDED. TERUMOBCT WAS NOTIFIED. IT WAS FOUND THE SECOND BAG OF ACD-A HUNG WAS NOT PROPERLY INFUSING INTO THE PRODUCT, THOUGH NO ALARMS WERE PRODUCED TO NOTIFY THE OPERATOR OF THE INTERRUPTED AC FLOW. APHERESIS KIT # 2010093130, EXP 10/1/22; ACD-A, LOT # 20044084, EXP 10/1/22. THE PATIENT HAD TO RETURN A SUBSEQUENT TO RE-COLLECT. FDA SAFETY REPORT ID# (B)(4).