NXSTAGE PUREFLOW B SOLUTION 5000ML RFP-401

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-01-23 for NXSTAGE PUREFLOW B SOLUTION 5000ML RFP-401 manufactured by Nxstage Medical, Inc..

Event Text Entries

[176049766] Crrt bag exploded while nurse was opening the bag. Rfp-401 bag. Lot q1910715. Nxstage pureflow b solution 5000ml.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9621543
MDR Report Key9621543
Date Received2020-01-23
Date of Report2019-11-22
Date of Event2019-11-21
Report Date2019-11-22
Date Reported to FDA2019-11-22
Date Reported to Mfgr2020-01-23
Date Added to Maude2020-01-23
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameNXSTAGE PUREFLOW B SOLUTION 5000ML
Generic NameDIALYSATE CONCENTRATE FOR HEMODIALYSIS (LIQUID OR POWDER)
Product CodeKPO
Date Received2020-01-23
Model NumberRFP-401
Lot NumberQ1910715
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age1 DA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerNXSTAGE MEDICAL, INC.
Manufacturer Address350 MERRIMACK STREET LAWRENCE MA 01843 US 01843


Patients

Patient NumberTreatmentOutcomeDate
10 2020-01-23

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