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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: CONCORD MANUFACTURING 2008K2 HEMODIALYSIS SYS OLC/DP, SPANISH; DIALYZER, HIGH PERMEABILITY WITH OR WITHOUT SEALED DIALYSATE SYSTEM

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CONCORD MANUFACTURING 2008K2 HEMODIALYSIS SYS OLC/DP, SPANISH; DIALYZER, HIGH PERMEABILITY WITH OR WITHOUT SEALED DIALYSATE SYSTEM Back to Search Results
Catalog Number 190618
Device Problem Melted (1385)
Patient Problem No Patient Involvement (2645)
Event Date 01/23/2019
Event Type  malfunction  
Manufacturer Narrative
The plant investigation is in process.A supplemental mdr will be submitted upon completion of this activity. .
 
Event Description
A user facility reported a fresenius 2008k2 machine with a melted unspecified component that was found in heat disinfect mode.It was confirmed there was no patient involvement.Due diligence attempts were exhausted, but additional information was not provided.If additional information is provided, a supplemental report will be submitted.
 
Manufacturer Narrative
Plant investigation: no parts were returned to the manufacturer for physical evaluation.A records review was performed on the reported serial number.An investigation of the device manufacturing records was conducted by the manufacturer.There were no non-conformances, or any associated rework identified during the manufacturing process which could be related to the reported event.In addition, the device history record (dhr) review confirmed the results of the in-progress and final quality control (qc) testing met all requirements.It was confirmed that a fresenius mexico technician repaired the machine and returned it to service, and it was confirmed there were no sample parts available for return to the manufacturer.The investigation into the cause of the reported problem was not able to be confirmed.A definitive conclusion regarding the complaint incident cannot be reached without a physical examination of the complaint device.
 
Manufacturer Narrative
Additional information: it was confirmed the machine was repaired and returned to service, and confirmed that there were no samples available for return.
 
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Brand Name
2008K2 HEMODIALYSIS SYS OLC/DP, SPANISH
Type of Device
DIALYZER, HIGH PERMEABILITY WITH OR WITHOUT SEALED DIALYSATE SYSTEM
Manufacturer (Section D)
CONCORD MANUFACTURING
4040 nelson avenue
concord CA 94520
MDR Report Key8321285
MDR Text Key135600245
Report Number2937457-2019-00437
Device Sequence Number1
Product Code KDI
Combination Product (y/n)N
PMA/PMN Number
K994267
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup,Followup
Report Date 02/20/2019
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
Device Operator Health Professional
Device Catalogue Number190618
Was Device Available for Evaluation? No
Device Age MO
Initial Date Manufacturer Received 01/24/2019
Initial Date FDA Received02/08/2019
Supplement Dates Manufacturer Received02/18/2019
02/05/2019
Supplement Dates FDA Received02/19/2019
02/20/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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