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Adverse Event Report

BAXTER HEALTHCARE CORP. BAXTER CA210 (HF/CA/2.1/M) DIALYZER   back to search results
Catalog Number 0102103
Event Date 11/11/1994
Patient Outcome  Required Intervention;
Event Description

Facility alleges dialyzer blood leak. Ebl>100cc no pt injury reported.

 
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Brand NameBAXTER CA210 (HF/CA/2.1/M)
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 Key100055
MDR Report Key101633
Event Key95559
Report Number101633
Device Sequence Number1
Product CodeFJI
Report Source Distributor
Reporter Occupation Nurse
Type of Report Initial
Report Date 01/17/1996
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 Number0102103
Was Device Available For Evaluation? No
Is The Reporter A Health Professional? Yes
Was the Report Sent to FDA? No
Distributor Facility Aware Date11/11/1994
Event Location Outpatient Treatment Facility
Is the Device an Implant? No
Is this an Explanted Device? No Answer Provided

Database last updated on February 28, 2009

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