inforMED
MalfunctionMQS

SYSTEM 1000

Received Dec 7, 2012 · Event occurred Nov 1, 2012

Report 1416980-2012-06657 · MDR key 2862290

Device

Generic name

System, Hemodialysis, Access Recirculation Monitoring

Catalog number

S1000L3

Product problems

  • Device Operates Differently Than Expected

Patient

Not reported

  • Hypoglycemia
  • Dizziness
  • Weight Changes

Narrative

Description of Event or Problem

A NURSE CONTACTED BAXTER (B)(4) REGARDING AN ULTRAFILTRATION- HIGH REPORT WITH A TINA HEMODIALYSIS MACHINE, WHICH OCCURRED DURING THERAPY WHILE THE PATIENT WAS CONNECTED. THE NURSE STATED THAT THE PATIENT WAS 1.5 KG LOWER THAN THE EXPECTED WEIGHT AND THE PATIENT EXPERIENCED LOW BLOOD PRESSURE AND DIZZINESS. HOWEVER, THERE WAS NO PATIENT INJURY AND MEDICAL INTERVENTION WAS NOT REQUIRED AS THE PATIENT RECOVERED WITHOUT ASSISTANCE.

Additional Manufacturer Narrative

(B)(4). THE MACHINE WAS EVALUATED AND THE REPORTED PROBLEM WAS CONFIRMED; THE CAUSE WAS IDENTIFIED AS DAMAGED VALVE OF ULTRAFILTRATION SYSTEM. DURING A VISUAL INSPECTION, IT WAS NOTED THAT ONE OF THE MACHINES VALVES WAS DAMAGED. DUE TO THE DAMAGED VALVE CONDITION, FUNCTIONAL TESTS WERE NOT PERFORMED. A DEVICE HISTORY REVIEW AND SERVICE HISTORY REVIEW WERE PERFORMED WITH NO ISSUES NOTED.

Additional Manufacturer Narrative

(B)(4). THE DEVICE IS CURRENTLY IN THE PROCESS OF BEING EVALUATED BY THE BAXTER FIELD SERVICE ENGINEER (FSE) AT THE CUSTOMER LOCATION. A FOLLOW-UP MDR WILL BE SUBMITTED UPON THE COMPLETION OF THE EVALUATION OR IF ANY ADDITIONAL INFORMATION BECOMES AVAILABLE.