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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION; SET, ADMINISTRATION, FOR PERITONEAL DIALYSIS, DISPOSABLE
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BAXTER HEALTHCARE CORPORATION; SET, ADMINISTRATION, FOR PERITONEAL DIALYSIS, DISPOSABLE Back to Search Results
Device Problem Improper or Incorrect Procedure or Method (2017)
Patient Problem Peritonitis (2252)
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 peritonitis was further described as improper operation.The patient was hospitalized and treated with an unspecified anti-inflammatory medication for peritonitis.Pd therapy was ongoing in the early stage of treatment.At the time of this report, the condition continued to recur after treatment and pd therapy was discontinued.Patient outcome was not reported.The reporter declined to provide additional information.
 
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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 Key18903198
MDR Text Key337652254
Report Number1416980-2024-01123
Device Sequence Number1
Product Code KDJ
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
NI
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Consumer,Company Representative
Reporter Occupation Other
Type of Report Initial
Report Date 03/14/2024
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
Initial Date Manufacturer Received 02/21/2024
Initial Date FDA Received03/14/2024
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
DIANEAL
Patient Outcome(s) Hospitalization; Required Intervention;
Patient SexMale
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