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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION CLEARLINK; SET, ADMINISTRATION, INTRAVASCULAR

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BAXTER HEALTHCARE CORPORATION CLEARLINK; SET, ADMINISTRATION, INTRAVASCULAR Back to Search Results
Model Number 2R8403
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a clearlink system solution set leaked from an unspecified location.This was observed during an unspecified location.There was no report of patient injury or medical intervention associated with this event.No additional information is available.
 
Additional Manufacturer Narrative
Should additional relevant information become available, a supplemental report will be submitted.
 
Additional Manufacturer Narrative
Additional information was added to h6.H11: a batch review was conducted and there were no deviations found related to this reported condition during the manufacture of this lot.The device was not received for evaluation; therefore, a device analysis could not be completed.Should additional relevant information become available, a supplemental report will be submitted.
 
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Brand Name
CLEARLINK
Common Device Name
SET, ADMINISTRATION, INTRAVASCULAR
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
2242705355
MDR Report Key24205308
Report Number1416980-2026-00387
Device Sequence Number18547912
Product Code FPA
UDI-Device Identifier00085412656649
UDI-Public(01)00085412656649(10)DR21E21062(17)230524
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K112893
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 03/09/2026
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 Expiration Date05/24/2023
Device Model Number2R8403
Device Catalogue Number2R8403
Device Lot NumberDR21E21062
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/02/2026
Supplement Date Received by Manufacturer02/10/2026
Initial Report FDA Received Date01/28/2026
Supplement Report FDA Received Date03/09/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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
Concomitant Medical Products
and Therapy/Usage Dates
NI.
Patient SexUnknown
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