inforMED
InjuryFPB

PALL IV FILTER 0.2 MM

Received Sep 23, 2022 · Event occurred Sep 13, 2022

Report MW5112259 · MDR key 15485289

Device

Generic name

Filter, Infusion Line

Manufacturer

Pall Corporation

Lot number

22-537

Product problems

  • Disconnection
  • Fluid/Blood Leak

Patient

Unknown

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

Narrative

Description of Event or Problem

FILTER BROKE LOOSE FROM THE CONNECTION TO THE IV TUBING SET AFTER BEING APPROPRIATELY CONNECTED AND LEAKED ONTO THE FLOOR. CHEMOTHERAPY SPILL HAD TO BE CLEANED BY NURSING STAFF. FDA SAFETY REPORT ID # (B)(4).