inforMED
MalfunctionMSE

F5 DIALYZER FINISHED ASSY

Received May 19, 2011 · Event occurred Apr 22, 2011

Report 1713747-2011-00012 · MDR key 2117139

Device

Generic name

Dialyzer

Model number

NA

Catalog number

0500162R

Lot number

10LU04012

Product problems

  • Leak/Splash

Patient

15 YR

  • Blood Loss

Narrative

Additional Manufacturer Narrative

(B)(6).

Description of Event or Problem

WHILE PATIENT WAS RECEIVING HER HEMODIALYSIS TREATMENT, THE NURSE NOTICED BLOOD LEAKING FROM THE VENOUS HEADER END CAP. IT WAS REPORTED THAT THE ESTIMATED BLOOD LOSS WAS 10 ML. THE NURSE REPORTED THAT THE HEADER END CAP WAS NOT TIGHTLY SEALED AND THAT THEY TRIED TIGHTENING IT. THEY BELIEVE THIS WAS THE CAUSE OF THE BLOOD LEAK. THE NURSE SAID THAT THE PATIENT IS FINE. THIS PATIENT DID COMPLETE THE ENTIRE TREATMENT AFTER THIS EVENT WITH USE OF NEW PRODUCT WITHOUT FURTHER INCIDENT. THERE IS NO REPORTED ILL EFFECT OR MEDICAL TREATMENT GIVEN. A SAMPLE IS AVAILABLE FOR AN EVALUATION. THE PATIENT WAS DISCHARGED TO HER HOME WHEN THE TREATMENT WAS COMPLETE.