inforMED
MalfunctionFPB

MICRO-VOLUME EXTENSION SET

Received Jul 10, 2023 · Event occurred Jun 2, 2023

Report 1416980-2023-03454 · MDR key 17293117

Device

Generic name

Filter, Infusion Line

Model number

NA

Catalog number

2N3350

Lot number

ASKU

Product problems

  • Crack
  • Fluid/Blood Leak
  • Crack
  • Fluid/Blood Leak

Patient

Unknown

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

Narrative

Additional Manufacturer Narrative

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

E1: INITIAL REPORTER ADDRESS: (B)(6). SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem

IT WAS REPORTED THAT THE FILTER OF A NON-DEHP MICRO-VOLUME EXTENSION SET WAS CRACKED AND LEAKED. THIS WAS IDENTIFIED DURING PATIENT INFUSION WITH LORAZEPAM USING A NON-BAXTER INFUSION PUMP. THE LEAK WAS EITHER FROM THE BONDED JOINT WHERE THE TUBING ENTERS THE FILTER OR FROM THE AIR VENT OF THE FILTER. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.