inforMED
MalfunctionFPB

MICRO-VOLUME EXTENSION SET

Received Apr 30, 2021 · Event occurred Jan 14, 2021

Report 1416980-2021-02527 · MDR key 11751917

Device

Generic name

Filter, Infusion Line

Model number

NA

Catalog number

2N3350

Lot number

ASKU

Product problems

  • Fluid/Blood Leak
  • Fluid/Blood Leak

Patient

Not reported

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

ADDITIONAL INFORMATION: D9, H3 AND H6. H10: THE DEVICE WAS RECEIVED FOR EVALUATION. VISUAL INSPECTION DID NOT IDENTIFY ANY ABNORMALITIES THAT COULD HAVE CONTRIBUTED TO THE REPORTED CONDITION. FUNCTIONAL TESTING WAS PERFORMED, INCLUDING PRESSURE AND CLEAR PASSAGE TESTING; AND NO BLOCKAGE OR LEAKS WERE OBSERVED. FURTHERMORE, PULL TESTING WAS COMPLETED WITH NO SEPARATION DETECTED. THE REPORTED CONDITION WAS NOT VERIFIED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative

SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem

IT WAS REPORTED A NON-DEHP MICRO-VOLUME EXTENSION SET LEAKED. IT WAS FURTHER REPORTED THE LEAK ORIGINATED AT THE FILTER. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.