inforMED
MalfunctionFLD

MARS

Received Nov 21, 2021 · Event occurred Oct 28, 2021

Report 3007697864-2021-00001 · MDR key 12849953

Device

Generic name

Apparatus, Hemoperfusion, Sorbent

Model number

NA

Catalog number

800541

Lot number

ASKU

Product problems

  • Fluid/Blood Leak
  • Fluid/Blood Leak

Patient

Unknown

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

Narrative

Additional Manufacturer Narrative

H10: THE DEVICE WAS NOT RETURNED AND THE LOT NUMBER IS UNKNOWN; THEREFORE, A DEVICE ANALYSIS COULD NOT BE COMPLETED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Additional Manufacturer Narrative

INITIAL REPORTER: PHONE NUMBER: (B)(6). SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem

IT WAS REPORTED THAT DURING TREATMENT WITH A MARS KIT, A POUT TOO HIGH #04 ALARM WAS TRIGGERED. A FLUID LEAK WAS OBSERVED AT THE TOP OF MARSFLUX DIALYZER AND A AMOUNT OF AIR WAS PRESENT INSIDE THE CIRCUIT. TREATMENT WAS INTERRUPTED. THERE WAS NO PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.