inforMED
MalfunctionMRZ

NOT PROVIDED

Received Jan 18, 2023 · Event occurred Jan 1, 2023

Report 9615050-2023-00011 · MDR key 16195054

Device

Generic name

Accessories, Pump, Infusion

Catalog number

UNKNOWN

Lot number

UNKNOWN

Product problems

  • Air/Gas in Device
  • Air/Gas in Device

Patient

Unknown

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

Narrative

Additional Manufacturer Narrative

THE COMPLAINT OF ALLOWS AIR IN LINE COULD NOT BE CONFIRMED BY INVESTIGATION. NO PRODUCT SAMPLES, PICTURES, OR VIDEOS WERE RECEIVED FOR INVESTIGATION. WITHOUT THE RETURN OF THE SAMPLE A COMPREHENSIVE FAILURE INVESTIGATION CANNOT BE PERFORMED AND A CAUSE CANNOT BE DETERMINED.

Additional Manufacturer Narrative

EVALUATION OF THE DEVICE IS ANTICIPATED. HOWEVER, THE DEVICE HAS NOT YET BEEN RETURNED TO THE MANUFACTURER.

Description of Event or Problem

THE EVENT INVOLVED AN UNKNOWN SAPPHIRE SET. THE CUSTOMER REPORTED THAT THEY OBSERVED AIR BUBBLES IN THE TUBING DESPITE PRIMING. THE CUSTOMER STATED THAT THE PRODUCT WAS EITHER LOT: 484956 (SAPPHIRE PRIMARY PIGGYBACK SET, 15 MICRON FILTER IN SIGHT CHAMBER, 2 CLAVE Y-SITES, 281 CM) OR LOT: 5287480 (SAPPHIRE PRIMARY 1.2 MICRON FILTER SET, NON-VENTED, CLAVE Y-SITE, 289 CM). THE DATE OF THE EVENT WAS UNKNOWN. THE STATUS OF THE PRODUCT AT THE TIME OF EVENT IS UNKNOWN. THERE WAS UNKNOWN PATIENT INVOLVEMENT AND UNKNOWN HUMAN HARM.