Customer reported via e-mail the following event: while infusing iv iron into the venous port of the dialysis system, they noticed that there appeared to be iron spilled on the bottom of the dialysis machine under the venous port.
Although, the iv tubing was securely inserted and the luer lock was secure, it continued to leak.
The infusion was discontinued.
No patient harm or medical intervention was reported.
Manufacturer's report date: 03/23/2011.
The customer discarded the used set.
The cause of the leak could not be determined.
If the administration set was being used with the alaris pump, connection to a dialysis system would be considered off label use.