InjuryFKB

ALTHIN

Received Aug 8, 1994 · Event occurred Jun 15, 1994

Report 2243621-1994-00230 · MDR key 24873

Device

Generic name

Blood Port Adapter Non-sterile

Manufacturer

Althin Medical, Inc.

Catalog number

210-404

Lot number

1064

Product problems

Disconnection

Patient

71 YR

Hemodialysis

Narrative

Description of Event or Problem

FACILITY ALLEGES BLOOD LINE "POPPED OFF" BLOOD PORT ADAPTER. RN REPORTS BLOOD LOSS TO PT AT > 100CC, AS WELL AS BLOOD SPLASHING ON ARM & NECK OF NURSE. NO PT INJURY REPORTED NURSE REQUIRED NO TREATMENT.