MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION; SET, ADMINISTRATION, FOR PERITONEAL DIALYSIS, DISPOSABLE

Device Problem Improper or Incorrect Procedure or Method (2017)

Patient Problems Abdominal Pain (1685); Fatigue (1849); Peritonitis (2252)

Event Date 01/17/2024

Event Type  Injury  

Manufacturer Narrative

This report is for a breach in aseptic technique which resulted in peritonitis. per baxter labeling, users are instructed to use aseptic technique when performing peritoneal dialysis therapy. should additional relevant information become available, a supplemental report will be submitted.

Event Description

A peritoneal dialysis (pd) patient experienced a breach in aseptic technique which resulted in peritonitis.The breach in aseptic technique was not further described.The peritonitis was manifested by severe weakness, cloudy pd fluid and abdominal pain.A day prior to the peritonitis diagnosis, the patient was hospitalized due to another indication.The patient was treated with vancomycin injection (1gm, intraperitoneal, every 72 hourly, ongoing), ceftazidime injection (1gm, intraperitoneal, once daily, ongoing) and fluconazole tablet (150mg, oral, once daily, ongoing) for peritonitis.At the time of this report, the patient remained hospitalized and was recovering from the events.Pd therapy was ongoing.It was reported that the patient was retrained on the proper aseptic technique.No additional information is available.

Manufacturer Narrative

Additional information: b5, b6 and b7.B5: upon follow-up, it was reported that antibiotic treatment was discontinued (on an unknown date).On an unknown date, the pd catheter was removed, pd therapy was discontinued and the patient was transferred to hemodialysis.At the time of this report, the patient has recovered from abdominal pain; however, was recovering from peritonitis, severe weakness, abdominal pain and cloudy pd fluid.The device was not returned and the lot number is unknown; therefore, a device analysis could not be completed.Should additional relevant information become available, a supplemental report will be submitted.

• Brand Name: NI
• Type of Device: SET, ADMINISTRATION, FOR PERITONEAL DIALYSIS, DISPOSABLE
• Manufacturer (Section D): BAXTER HEALTHCARE CORPORATION; deerfield IL
• Manufacturer (Section G): BAXTER HEALTHCARE CORPORATION; ni; ni; ni
• Manufacturer Contact: 25212 w. illinois route 120; round lake, IL 60073 ; 2242702068
• MDR Report Key: 18672750
• MDR Text Key: 334947013
• Report Number: 1416980-2024-00441
• Device Sequence Number: 1
• Product Code: KDJ
• Combination Product (y/n): N
• Reporter Country Code: IN
• PMA/PMN Number: NI
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Health Professional,Company Representative
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial,Followup
• Report Date: 03/04/2024

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Lay User/Patient
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 01/17/2024
• Initial Date FDA Received: 02/08/2024
• Supplement Dates Manufacturer Received: 02/09/2024
• Supplement Dates FDA Received: 03/04/2024
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1
• Treatment: DIANEAL PD2 2.5%.; EXTRANEAL PD2 7.5%.; UNKNOWN BAXTER PD DISPOSABLES.; UNKNOWN PD CATHETER.
• Patient Outcome(s): Hospitalization; Required Intervention
• Patient Age: 48 YR
• Patient Sex: Male