inforMED
InjuryFKY

DISPOSABLE BLOOD TUBE SET

Received Aug 14, 2023 · Event occurred Jul 24, 2023

Report 3013536188-2023-00006 · MDR key 17540471

Device

Generic name

Disposable Blood Tube Set

Model number

SC-14358

Catalog number

SC-14358

Lot number

2303SA211

Product problems

  • Improper or Incorrect Procedure or Method
  • Improper or Incorrect Procedure or Method

Patient

Unknown

  • Hemorrhage/Blood Loss/Bleeding
  • Hemorrhage/Blood Loss/Bleeding

Narrative

Additional Manufacturer Narrative

UDI: (B)(4). QUANTA IS CURRENTLY INVESTIGATING THE REPORTED FAULT AND WILL PROVIDE INVESTIGATION RESULTS UPON CONCLUSION. THE SAMPLE IS PRESENTLY IN TRANSIT ANDUPON RECEIPT WE WILL PROVIDE ADDITIONAL INFORMATION. QUANTA TECHNICAL TEAM WILL CONTINUE TO INVESTIGATE THE ROOT CAUSE OF THE REPORTED ISSUE. A CAPA HAS BEEN INITIATED TO IDENTIFY AND DEFINE ANY ADDITIONAL MITIGATIONS TO BE ADDED TO FURTHER MITIGATE THE RISKS ASSOCIATED WITH THIS ISSUE. THE SAMPLE IS PRESENTLY IN TRANSIT AND QUANTA WILL DO A THOROUGH PRODUCT INVESTIGATION.

Description of Event or Problem

A HOME HEMODIALYSIS PATIENT REPORTED THAT DURING THEIR HEMODIALYSIS TREATMENT ON (B)(6), 2023, THEY SUFFERED A BLOOD LOSS WHILE ON DIALYSIS. THE PATIENT ADVISED THAT BLOOD LEAK WAS COMING FROM THE TOP OF THE PERISTALTIC LOOP ON THE BLOOD TUBE SET. THE PATIENT WAS UNABLE TO COMPLETE TREATMENT. THE PATIENT ESTIMATED LOSING ROUGHLY 500ML OF BLOOD. THE PATIENT DID NOT SEEK MEDICAL INTERVENTION DURING INCIDENT; HOWEVER, THE PATIENT LATER COMMUNICATED WITH THEIR RENAL UNIT AND WILL CONTINUE TO DO TREATMENT IN-CENTER.