ULTRAFILTER HECHINGEN
Received Apr 10, 2025 · Event occurred Mar 15, 2025
Report 9611369-2025-00051 · MDR key 21816871
Device
Generic name
Subsystem, Water Purification
Manufacturer
Vantive Us Healthcare LlcModel number
NACatalog number
955826
Lot number
4-1700-H-01
Product problems
- Fluid/Blood Leak
- Fluid/Blood Leak
Patient
NA · Unknown
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Additional Manufacturer Narrative
E1: INITIAL REPORTER ADDRESS- (B)(6). THE DEVICE WAS RECEIVED, AND PHOTOGRAPHS OF THE SAMPLE WERE PROVIDED FOR EVALUATION. VISUAL INSPECTION OF THE PHOTOS AND ACTUAL SAMPLE DID NOT IDENTIFY ANY ABNORMALITIES THAT COULD HAVE CONTRIBUTED TO THE REPORTED CONDITION. FUNCTIONAL LEAK TESTING WAS PERFORMED ON THE DEVICE DIALYSATE SIDE, AND NO LEAKAGE WAS OBSERVED. A BATCH REVIEW WAS CONDUCTED AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. THE REPORTED CONDITION WAS NOT VERIFIED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.
Description of Event or Problem
IT WAS REPORTED THAT AN EXTERNAL FLUID LEAK WAS OBSERVED FROM A U9000 PLUS ULTRAFILTER DURING PREPARATION TESTING FOR HEMODIALYSIS THERAPY. THERE WAS NO PATIENT INVOLVEMENT. NO ADDITIONAL INFORMATION IS AVAILABLE.
Additional Manufacturer Narrative
CORRECTION: F11, F12. THE INITIAL REPORT INADVERTENTLY INCLUDED INFORMATION IN F11: REPORT SENT TO FDA AND F12: LOCATION WHERE EVENT OCCURRED. THIS INFORMATION IS BEING REMOVED AS THIS MDR IS A MANUFACTURER MDR (AND NOT AN IMPORTER MDR). SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.