inforMED
MalfunctionFIL

FRESENIUS DIALYSIS DELIVERY SYSTEM

Received Oct 11, 2001 · Event occurred Sep 3, 2001

Report 2937457-2001-00023 · MDR key 356096

Device

Generic name

Hemodialysis Machine

Model number

2008K

Catalog number

NA

Lot number

NA

Product problems

  • Insufficient Flow or Under Infusion

Patient

39 YR

  • Low Blood Pressure/ Hypotension
  • Nausea
  • Dizziness
  • Therapy/non-surgical treatment, additional
  • Treatment with medication(s)
  • Weight Changes

Narrative

Description of Event or Problem

A DIALYSIS FACILITY REPORTED THAT THERE WAS EXCESSIVE FLUID REMOVED FROM A PATIENT DURING A HEMODIALYSIS TREATMENT. THE PATIENT BECAME HYPOTENSIVE AND C/O NAUSEA AND DIZZINESS ONE AND A HALF HOUR INTO THE TREATMENT. PATIENT WAS GIVEN A LITER OF SALINE AND WEIGHED. PATIENT'S WEIGHT INDICATED A WEIGHT LOSS OF 4.2 KG. THE MACHINE SHOWED THAT 2,710 ML WAS REMOVED. ADDITIONAL SALINE WAS GIVEN AND TREATMENT WAS COMPLETED WITH THE "UF" OFF. THERE WAS NO SERIOUS INJURY OR ILLNESS.