inforMED
MalfunctionFPB

MICRO-VOLUME EXTENSION SET

Received Jul 31, 2023 · Event occurred Apr 20, 2023

Report 1416980-2023-03829 · MDR key 17425700

Device

Generic name

Filter, Infusion Line

Model number

NA

Catalog number

2N3350

Lot number

DR22L09024

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

H10: A BATCH REVIEW WAS CONDUCTED AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. THE DEVICE WAS NOT RECEIVED FOR EVALUATION; 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 THE NON-DEHP MICRO-VOLUME EXTENSION SET WAS CRACKED ON THE BONDED SIDE WHERE THE IV TUBING WAS CONNECTED AND LEAKED OUT OF THE AIR VENT. THE ISSUE OCCURRED AFTER PRIMING. THE SET WAS USED WITH A MEDFUSION SYRING PUMP. THERE WAS NO PATIENT INVOLVEMENT. NO ADDITIONAL INFORMATION IS AVAILABLE.