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Adverse Event Report

BAXTER HEALTHCARE CORP BAXTER CA110 (HF/CA/1.1/L) DIALYZER   back to search results
Catalog Number 0117325
Event Date 01/11/1991
Patient Outcome  Required Intervention;
Event Description

Dr facility alleges the dialyzer leaked on reuse #5. Ebl > 100 cc.

 
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Brand NameBAXTER CA110 (HF/CA/1.1/L)
Type of DeviceDIALYZER
Baseline Device 510(K) Number
Baseline Device PMA Number
Manufacturer (Section F)
BAXTER HEALTHCARE CORP
p.o. box 7780-5030
philadelphia PA 19182
Manufacturer (Section D)
BAXTER HEALTHCARE CORP
p.o. box 7780-5030
philadelphia PA 19182
Device Event Key112450
MDR Report Key114555
Event Key107737
Report Number114555
Device Sequence Number1
Product CodeFJI
Report Source Distributor
Reporter Occupation Nurse
Type of Report Initial
Report Date 02/08/1996
1 Device Was Involved in the Event
1 Patient Was Involved in the Event
Date FDA Received04/24/1996
Is This An Adverse Event Report? Yes
Is This A Product Problem Report? No
Device Operator Health Professional
Device Catalogue Number0117325
Was Device Available For Evaluation? No
Is The Reporter A Health Professional? Yes
Was the Report Sent to FDA? No
Distributor Facility Aware Date01/11/1991
Event Location Outpatient Treatment Facility
Is the Device an Implant? No
Is this an Explanted Device? No Answer Provided

Database last updated on January 30, 2009

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