inforMED
MalfunctionFRA

LS HEMA Y-TP BLD CLV

Received May 18, 2015 · Event occurred Mar 1, 2015

Report 9615050-2015-01099 · MDR key 4787220

Device

Generic name

80 Fra

Model number

NA

Catalog number

12434

Lot number

441365H

Product problems

  • Material Separation

Patient

NA

  • No Patient Involvement

Narrative

Description of Event or Problem

THE CUSTOMER CONTACT REPORTED THAT ONE OF THE TUBES THAT LEAD FROM THE SPIKE TO THE DRIP CHAMBER WAS LOOSE, SUBSEQUENTLY A LEAK WAS NOTED. IT WAS REPORTED THAT DURING PRIMING, PRIOR TO PT USE, FLUID WAS FOUND AROUND THE OUTSIDE OF THE DRIP CHAMBER, THE BUBBLES OCCURRING AT THE CONNECTION WHEN DRIP CHAMBER WAS SQUEEZED. IT WAS FURTHER REPORTED, THAT WHEN THE TUBING SET WAS PLACED BACK IN THE PACKAGING, ONE OF THE TUBES THAT LEADS FROM THE SPIKE TO THE BLOOD FILTER HOUSING ASSEMBLY CAME APART WHERE IT ENTERED THE BLOOD FILTER HOUSING ASSEMBLY. THERE WERE NO REPORTED ADVERSE PT EVENTS AND NO REPORTED DELAY OF THERAPY CRITICAL FOR THE PT. NO MEDICAL INTERVENTIONS WERE REQUIRED. NO ADD'L INFO WAS PROVIDED.

Additional Manufacturer Narrative

THE DEVICE WAS REC'D. INVESTIGATION IS NOT COMPLETE. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.