MICRO-VOLUME EXTENSION SET
Received May 5, 2021 · Event occurred Jan 31, 2021
Report 1416980-2021-02695 · MDR key 11779654
Device
Generic name
Filter, Infusion Line
Manufacturer
Baxter Healthcare CorporationModel number
NACatalog number
2N3350
Lot number
ASKU
Product problems
- Crack
- Disconnection
- Crack
- Disconnection
Patient
Not reported
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
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 DISCONNECTED AND APPEARED CRACKED. DURING AN UNSPECIFIED SOLUTION INFUSION VIA A 50ML SYRINGE AT 1ML/HOUR, THE TUBING BECAME DISLODGED DUE TO A ¿POSSIBLE CRACKED CONNECTION PIECE¿. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.
Additional Manufacturer Narrative
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.