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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAXTER HEALTHCARE CORPORATION CLEARLINK/DUO-VENT; SET, ADMINISTRATION, INTRAVASCULAR

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BAXTER HEALTHCARE CORPORATION CLEARLINK/DUO-VENT; SET, ADMINISTRATION, INTRAVASCULAR Back to Search Results
Model Number 2C8419
Medical Device Problem Code Misconnection (1399)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Should additional relevant information become available, a supplemental report will be submitted.
 
Event or Problem Description
It was reported that the luer lock mechanism of a clearlink system solution set did not slide down to the hub for securement.This was observed during an unspecified process step.There was no report of patient injury or medical intervention associated with this event.No additional information is available.
 
Additional Manufacturer Narrative
Additional information: h4, h6(update codes), h11.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/DUO-VENT
Common Device Name
SET, ADMINISTRATION, INTRAVASCULAR
Manufacturer (Section D)
BAXTER HEALTHCARE CORPORATION
deerfield IL
Manufacturer (Section G)
BAXTER HEALTHCARE - CARTAGO
parque industrial de cartago
apartado no. 1-7052
cartago
CS  
Manufacturer Contact
25212 w. illinois route 120
round lake, IL 60073
2242705355
MDR Report Key24514902
Report Number1416980-2026-00837
Device Sequence Number8430683
Product Code FPA
UDI-Device Identifier00085412048956
UDI-Public(01)00085412048956(10)R25I04079
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 Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 04/02/2026
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 Model Number2C8419
Device Catalogue Number2C8419
Device Lot NumberR25I04079
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/03/2026
Supplement Date Received by Manufacturer03/26/2026
Initial Report FDA Received Date03/05/2026
Supplement Report FDA Received Date04/02/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/06/2025
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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