MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 1996-10-11 for LUNDIA ALPHA 700 NO1849004 manufactured by Gambro Healthcare.
[29499]
During a dialysis treatement, there was an external leak at the sealing plug above the label on the arterial end of the dialyzer. Rinseback was completed so there was no blood loss. There was no pt injury or medical intervention.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 8030992-1996-00006 |
| MDR Report Key | 42888 |
| Report Source | 05 |
| Date Received | 1996-10-11 |
| Date of Report | 1996-10-11 |
| Date of Event | 1996-07-05 |
| Date Facility Aware | 1996-07-05 |
| Report Date | 1996-10-11 |
| Date Mfgr Received | 1996-09-12 |
| Date Added to Maude | 1996-10-21 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | NA |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | LUNDIA ALPHA 700 |
| Generic Name | PLATE DIALYZER |
| Product Code | FJG |
| Date Received | 1996-10-11 |
| Model Number | LUNDIA ALPHA 700 |
| Catalog Number | NO1849004 |
| Lot Number | 6-0092-L01 |
| ID Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | * |
| Device Eval'ed by Mfgr | R |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 43866 |
| Manufacturer | GAMBRO HEALTHCARE |
| Manufacturer Address | 1185 OAK ST LAKEWOOD CO 80215 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 1996-10-11 |