inforMED
MalfunctionFPB

FILTER, INFUSION LINE

Received Mar 12, 2019 · Event occurred Jan 16, 2019

Report 2245270-2019-00006 · MDR key 8414033

Device

Generic name

Filter, Infusion Line

Manufacturer

Vygon Usa

Model number

AMS-426-1

Lot number

1807049D

Product problems

  • Fluid/Blood Leak
  • Fluid/Blood Leak

Patient

Not reported

  • No Information
  • No Information

Narrative

Additional Manufacturer Narrative

THERE WERE THREE OCCURRENCES WITHIN THIS COMPLAINT. THOSE OCCURRENCES WERE CAPTURED IN THE FOLLOWING MDRS: 2245270-2019-00007, 2245270-2019-00008. ALTHOUGH THE DEVICE WAS NOT RETURNED TO VYGON, THE DETAILS OF THE COMPLAINT WILL BE EXAMINED AS PART OF THE COMPLAINT INVESTIGATION. THIS INVESTIGATION IS CURRENTLY IN PROCESS AND THE RESULTS WILL BE FORWARDED TO FDA WITHIN 30 DAYS OF ITS CONCLUSION VIA FOLLOW-UP MDR.

Description of Event or Problem

(B)(6) CALLED TO REPORT AN INCIDENT REGARDING SIGNIFICANT LEAK (PUDDLE ON FLOOR BY PATIENT) FROM EXTENSION SET NEAR CONNECTION WITH PUMP. LEAK INVOLVED HAZARDOUS CHEMO DRUG. DUE TO EXTENT OF CONTAMINATION, ALL COMPONENTS, FLUIDS, ETC. WERE DISPOSED OF AS HAZARDOUS WASTE. NO LEAKAGE NOTED UNTIL AFTER PATIENT WAS SWITCHED TO NS FLUSH BAG. PUMP DID NOT BEEP OR ALARM. PEMBROLIZUMAB INFUSED FOR 24 MINUTES AND NS INFUSED FOR 10ML.