inforMED
MalfunctionMAC

LEVCOREDUCTION FILTER

Received Jul 9, 2004 · Event occurred May 20, 2004

Report 9710488-2004-00001 · MDR key 5404929

Device

Generic name

Medical Device

Model number

KSV0002XD

Lot number

284803G22

Product problems

  • Fluid/Blood Leak
  • Filtration Problem

Patient

Not reported

  • No Known Impact Or Consequence To Patient

Narrative

Additional Manufacturer Narrative

NO. 133900 FILTER SIMILAR PRODUCTS SOLD IN (B)(6) WITHOUT ANY COMPLAINT ABOUT LEAK. POTENTIAL CONTAMINATION VERY LOW. INVESTIGATION STILL ONGOING AT THIS DATE.

Description of Event or Problem

LOSS OF INTEGRITY OF THE FILTER DURING FILTRATION. BLOOD LEAKED FROM FILTER. FILTRATION CONDITION: BLOOD STORAGE 1 DEGREE BEFORE FILTRATION 22 CELSIUS. BLOOD STORAGE TIME BEFORE FILTRATION 5 HOURS. FILTRATION 1 DEGREE - 22 CELSIUS. FILTRATION TIME; APPROX. 6MM. BLOOD CENTER: GULF COAST. DURATION NUMBER: (B)(4).