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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION INTRAVIA; CONTAINER, I.V.

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BAXTER HEALTHCARE CORPORATION INTRAVIA; CONTAINER, I.V. Back to Search Results
Model Number 2B8012
Medical Device Problem Code Device Contamination with Chemical or Other Material (2944)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
B3: the event occurred either on august 4, 19 or 22, 2025.E1: initial reporter address: (b)(6).Should additional relevant information become available, a supplemental report will be submitted.
 
Event or Problem Description
It was reported that two (2) 250 ml intravia containers had plastic particles inside the bag.This issue was identified during compounding while adding solution/drug to the bag and/or when removing air from bag.There was no patient involvement.No additional information is available.
 
Additional Manufacturer Narrative
Additional information was added to d9, h3, h4, and h6.H11: the devices were received for evaluation.A visual inspection was performed, and it was noted that the units were wet and cut at the corner of the bags by the end user.No particles were observed inside the bag; however, this could have been due to the particles coming out once the bag was cut, releasing the solution inside by the end user.The reported condition could not be confirmed or refuted.The cause of the reported condition could not be determined.A batch review was conducted and there were no deviations found related to this reported condition during the manufacture of this lot.Should additional relevant information become available, a supplemental report will be submitted.
 
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Brand Name
INTRAVIA
Common Device Name
CONTAINER, I.V.
Manufacturer (Section D)
BAXTER HEALTHCARE CORPORATION
deerfield IL
Manufacturer (Section G)
BAXTER HEALTHCARE - HAINA
parque industrial itabo
carretera sanchez km 18 1/2
haina 21426
DR   21426
Manufacturer Contact
25212 w. illinois route 120
round lake, IL 60073
2242702068
MDR Report Key23098176
Report Number1416980-2025-04687
Device Sequence Number18334374
Product Code KPE
UDI-Device Identifier00085412003191
UDI-Public(01)00085412003191(10)DR22G18017
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K964853
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Pharmacist
Type of Report Initial,Followup
Report Date (Section B) 10/23/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Other
Device Model Number2B8012
Device Catalogue Number2B8012
Device Lot NumberDR22G18017
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/22/2025
Supplement Date Received by Manufacturer10/22/2025
Initial Report FDA Received Date09/19/2025
Supplement Report FDA Received Date10/23/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/19/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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