inforMED
MalfunctionKOC

COMBISET BLOODLINE

Received Aug 22, 2025 · Event occurred Aug 15, 2025

Report 0008030665-2025-01992 · MDR key 22873983

Device

Generic name

Accessories, Blood Circuit, Hemodialysis

Catalog number

03-2522-1

Lot number

25HR01130

Product problems

  • Fluid/Blood Leak
  • Fluid/Blood Leak

Patient

NA · Unknown

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

Narrative

Description of Event or Problem

A USER FACILITY CLINIC MANAGER (CM) REPORTED THERE WAS A HOLE IN THE ARTERIAL BLOOD LINE UNDER THE BLOOD PUMP ON THE RIGHT, RESULTING IN PATIENT LOSING BLOOD. THE ESTIMATED BLOOD LOSS (EBL) WAS UNKNOWN. PHOTOS WERE PROVIDED FOR THE INVESTIGATION. ADDITIONAL INFORMATION WAS REQUESTED BUT WAS NOT RECEIVED TO DATE.

Additional Manufacturer Narrative

PLANT INVESTIGATION: AS THE DEVICE WAS NOT RETURNED TO THE MANUFACTURER, A PHYSICAL EVALUATION COULD NOT BE PERFORMED. HOWEVER, A PICTURE WAS RECEIVED FROM THE CUSTOMER. DUE TO THE QUALITY OF PICTURE RECEIVED IT COULD NOT BE CONFIRMED THE SOURCE OF THE LEAK. THE REPORTED EVENT WAS NOT CONFIRMED WITH THE PICTURE RECEIVED. A BATCH RECORDS REVIEW WAS CONDUCTED BY THE MANUFACTURER FOR THE REPORTED LOT. THERE WERE NO NON-CONFORMANCES OR ABNORMALITIES IDENTIFIED DURING THE MANUFACTURING PROCESS WHICH COULD BE ASSOCIATED WITH THE REPORTED EVENT. THE ENTIRE LOT HAS BEEN SOLD AND DISTRIBUTED. IN ADDITION, A DEVICE HISTORY REVIEW WAS PERFORMED AND CONFIRMED THAT THE RESULTS OF THE IN-PROGRESS AND FINAL QUALITY CONTROL (QC) TESTING MET ALL REQUIREMENTS. THE LOT MET ALL SPECIFICATIONS FOR RELEASE. A PRODUCT HISTORY REVIEW DID NOT REVEAL A PROBABLE CAUSE FOR THE CUSTOMER COMPLAINT. AS A PHYSICAL EVALUATION COULD NOT BE PERFORMED, A DEFINITIVE CONCLUSION REGARDING THE REPORTED INCIDENT COULD NOT BE REACHED AND A CAUSE COULD NOT BE CONFIRMED.

Additional Manufacturer Narrative

PLANT INVESTIGATION: THE PLANT INVESTIGATION IS IN PROCESS. A SUPPLEMENTAL MDR WILL BE SUBMITTED UPON COMPLETION OF THIS ACTIVITY.

Description of Event or Problem

A USER FACILITY CLINIC MANAGER (CM) REPORTED THERE WAS A HOLE IN THE ARTERIAL BLOOD LINE UNDER THE BLOOD PUMP ON THE RIGHT, RESULTING IN PATIENT LOSING BLOOD. THE ESTIMATED BLOOD LOSS (EBL) WAS UNKNOWN. PHOTOS WERE PROVIDED FOR THE INVESTIGATION. ADDITIONAL INFORMATION WAS REQUESTED BUT WAS NOT RECEIVED TO DATE.