inforMED
MalfunctionFPB

MICRO-VOLUME EXTENSION SET

Received Sep 10, 2024 · Event occurred Aug 15, 2024

Report 1416980-2024-04869 · MDR key 20180310

Device

Generic name

Filter, Infusion Line

Model number

2N3350

Catalog number

2N3350

Lot number

NI

Product problems

  • Backflow
  • Backflow

Patient

NA · Unknown

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

Narrative

Additional Manufacturer Narrative

H11: 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.

Description of Event or Problem

IT WAS REPORTED THAT A MICRO-VOLUME EXTENSION SET HAD LIPIDS BACKING UP IN THE TUBING. THE BACKFLOW WAS CAUSING THE OCCLUSION LIMIT TO GO OFF ON THE PUMP. THIS OCCURRED DURING INFUSION. THERE WAS NO REPORT OF PATIENT INJURY OR MEDICAL INTERVENTION ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Additional Manufacturer Narrative

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