inforMED
MalfunctionFPA

ALARIS PUMP INFUSION SET

Received Jun 22, 2026 · Event occurred May 12, 2026

Report MW5189727 · MDR key 25580398

Device

Generic name

Set, Administration, Intravascular

Catalog number

2420-0007

Lot number

26035444

Patient

74 YR · Female

  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

PRIMARY LINE INFUSING IV POTASSIUM CHLORIDE BROKE FROM THE "MALE LUER" THAT ATTACHES TO THE Y-SITE. THIS MALFUNCTION RESULTED IN DISCONNECTION FROM THE PATIENT AND THE LINE TO LEAK KCL ON THE FLOOR. PRIMARY RN FOUND MALFUNCTION 5 MINUTES AFTER SECOND KCL BAG STARTED. LINE CONNECTED TO PATIENT AND MEDICATION BAG BOTH CLAMPED. AREA CLEANSED.