inforMED
MalfunctionFPB

MICRO-VOLUME EXTENSION SET

Received Jul 19, 2022

Report 1416980-2022-03714 · MDR key 15057727

Device

Generic name

Filter, Infusion Line

Model number

NA

Catalog number

2N3350

Lot number

DR22B18055

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

DATE OF BIRTH: NEONATAL. EVENT DATE: THIS EVENT OCCURRED DURING THE UNSPECIFIED DATE OF JUNE 2022. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem

IT WAS REPORTED THAT THE FILTER OF AN UNSPECIFIED QUANTITY OF A NON-DEHP MICRO-VOLUME EXTENSION SETS LEAKED. THE ISSUE WAS IDENTIFIED DURING USE. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Additional Manufacturer Narrative

H10: A BATCH REVIEW WAS CONDUCTED AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. THE DEVICES WERE DISCARDED; THEREFORE, A DEVICE ANALYSIS COULD NOT BE COMPLETED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.