inforMED
MalfunctionQAX

THERANOVA

Received Nov 22, 2023 · Event occurred Nov 1, 2023

Report 9611369-2023-00247 · MDR key 18194785

Device

Generic name

Hemodialyzer With Expanded Solute Removal Profile

Model number

NA

Catalog number

955367

Lot number

3-6954-H-01

Product problems

  • Fluid/Blood Leak
  • Fluid/Blood Leak

Patient

Unknown

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

Narrative

Additional Manufacturer Narrative

SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem

IT WAS REPORTED THAT DURING USE, ONE UNIT OF THERANOVA 400 HAD AN EXTERNAL FLUID LEAKAGE. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Additional Manufacturer Narrative

H10: THE ACTUAL DEVICE WAS NOT AVAILABLE; HOWEVER, PHOTOGRAPHS OF THE SAMPLE WERE PROVIDED FOR EVALUATION. THE RETURNED PHOTOGRAPHS WERE REVIEWED, AND IT WAS NOTED THAT THE PICTURES DID NOT SHOW ANYTHING RECOGNIZABLE AND THEREFORE NO DETAILED INVESTIGATION COULD BE PERFORMED. DUE TO THE ABSENCE OF AN ACTUAL SAMPLE THE ROOT CAUSE FOR THE REPORTED ISSUE COULD NOT BE IDENTIFIED. A BATCH REVIEW WAS CONDUCTED AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.