FILTERED EXTENSION SET 16IN FE2012F 473989

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-10-04 for FILTERED EXTENSION SET 16IN FE2012F 473989 manufactured by B. Braun Medical, Inc..

Event Text Entries

[123489441] After ocrevus finished infusing, and staff was taking it down, staff noted there was a puddle on the floor. On investigation, staff noted there was a leak from the iv tubing. Approximately 75- 100ml (about 120 mg) of medication had leaked onto the floor. Did receive remainder of infusion, approximately 150-170 ml or 180 mg. Provider aware, a leak in the filter extension set was noticed near the yellow port.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5080386
MDR Report Key7938716
Date Received2018-10-04
Date of Report2018-10-02
Date Added to Maude2018-10-05
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameFILTERED EXTENSION SET 16IN
Generic NameFILTER, INFUSION LINE
Product CodeFPB
Date Received2018-10-04
Model NumberFE2012F
Catalog Number473989
Lot Number0061618776
Device Availability*
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerB. BRAUN MEDICAL, INC.


Patients

Patient NumberTreatmentOutcomeDate
10 2018-10-04

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