MAUDE Adverse Event Report: UNKNOWN BAG DECANTER; CONTAINER, I.V.

Device Problems Product Quality Problem (1506); Device Markings/Labelling Problem (2911)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Description

Describe event, problem, or product use error: csi viperslide lubricant and intralipid both have a similar milky white appearance and packaged similar with a white and blue port.Viperslide is a non-drug product used as a lubricant in certain procedures and intralipid is a lipid injectable emulsion.There is a risk of a potential mix up since these products look very similar.We discovered a viperslide lubricant product in the pharmacy, which was returned back to pharmacy, possibly due to the fact that it looks like the intralipid product we carry.

• Brand Name: BAG DECANTER
• Type of Device: CONTAINER, I.V.
• Manufacturer (Section D): UNKNOWN
• MDR Report Key: 15699529
• MDR Text Key: 302922967
• Report Number: MW5112979
• Device Sequence Number: 2
• Product Code: MCX
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Pharmacist
• Type of Report: Initial
• Report Date: 10/27/2022
• 2 Devices were Involved in the Event: 1 2

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: No
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: Not provided
• Initial Date FDA Received: 10/28/2022
• Patient Sequence Number: 1