CPDA-1

20191118

6

CPDA-1 Anticoagulant Citrate Phosphate Dextrose Adenine Dextrose Monohydrate ANHYDROUS DEXTROSE Trisodium Citrate Dihydrate Anhydrous Citric Acid Anhydrous Citric Acid Anhydrous Citric Acid Sodium Phosphate, Monobasic, Monohydrate PHOSPHATE ION Adenine Adenine Sodium Hydroxide Water

BN770420

CPDA-1

Anticoagulant Citrate Phosphate Dextrose Adenine

0942-6307

HUMAN PRESCRIPTION DRUG

INTRAVENOUS

PACKAGE/LABEL DISPLAY PANEL Code 4R3647 24 Units Fenwal Blood-Pack Unit Double Anticoagulant Citrate Phosphate Dextrose Adenine Solution, USP (CPDA-1) For Collection and Processing of 500 mL Blood Sample Diversion System, 16 ga. Ultra Thin Wall Fenwal HighFlo Needle Rx only Each unit consists of a primary container with 70 mL of CPDA-1 solution containing 2.23 g Dextrose (monohydrate) USP, 1.84 g Sodium Citrate (dihydrate) USP, 209 mg Citric Acid (anhydrous) USP, 155 mg Monobasic Sodium Phosphate (monohydrate) USP and 19.3 mg Adenine USP, pH may have been adjusted with sodium hydroxide; one empty 400 mL PL 146 Plastic Transfer-Pack container. Sterile , non-pyrogenic fluid path. See instructions for use. Single use only. Store at Controlled Room Temperature (refer to direction insert). Protect from freezing. Avoid excessive heat. • Open pouch by tearing across at notch. • Direct handling of product surfaces prior to extended storage in the foil pouch, may result in mold growth. • Unused units in open foil pouch may be kept up to 60 days by folding and securing open end of foil pouch to prevent possible loss of moisture, provided: I. Units are not removed from foil pouch, or II. Unused units removed from foil pouch are returned to the foil pouch within 12 hours. Units may be removed from the pouch and returned only once. • Units removed from the foil pouch (that are not returned to the pouch within 12 hours) must be used within 4 days (96 hours). Units out of the foil pouch for longer than 96 hours must be discarded. Manufacturer Fresenius Kabi AG 61346 Bad Homburg / Germany www.fresenius-kabi.com Made in USA 47-28-13-529 REV: A 4r3644packlbl

4R3629, 4R3644, 4R3647 Fresenius Kabi Fenwal Blood-Pack Units Rx only Using Anticoagulant Citrate Phosphate Dextrose Adenine Solution, USP (CPDA-1) and Fenwal HighFlo Needle Contains Sample Diversion for the collection of whole blood samples for laboratory testing. Instructions for Use Collection Procedure: Use aseptic technique. Note: If Sample Diversion System is not used, donor samples may be collected using an alternate method following standard procedures. Note: Nominal tubing dimensions of product are 0.118" inner diameter x 0.025" wall thickness. Precautions: • Upon removal of Blood-Pack unit from the clear plastic overwrap, visually inspect the unit. • Do not use the product if the in-line cannula is broken and/or anticoagulant is present in the sample pouch or in the tubing from the in-line cannula to the sample pouch and donor needle (see Figure 1). Note that condensation in the empty tubing of the Blood-Pack unit is expected as a result of the sterilization process. • Do not use unless the solution is clear. 1. Identify Blood-Pack unit using appropriate donor identification system. 2. Donor scale • Adjust donor scale to desired collection weight. • Position primary container on the donor scale as far as possible below donor arm. 3. Clamp donor tubing between the Fenwal HighFlo1 needle and Y-junction. (This step can be performed prior to step 1 or 2.) 4. Visually inspect the tubing from the in-line cannula to the sample pouch and donor needle, as well as the sample pouch to reconfirm that there is no anticoagulant present. Note: Ensure that the sample pouch remains below the donor’s arm. 5. Following blood center procedures, apply pressure to donor’s arm and disinfect site of venipuncture. 6. Remove needle cover per instructions below: • Holding the hub and cover near the tamper-evident seal, twist cover and hub in opposite directions to break seal. • Remove needle cover, being careful not to drag the cover across the needle point. 7. Following blood center procedures, perform venipuncture, appropriately secure donor needle and/or tubing and release hemostat. 8. When good blood flow is established, stabilize the front of the needle guard to arm with tape. (see Figure 2) 9. Allow the sample pouch to fill with blood according to center procedure. Monitor blood flow into sample pouch. Notes: • The sample pouch contains an average fill volume of approximately 53 mL with a maximum fill volume of approximately 60 mL when filled to capacity. • If less blood sample volume is required, the flow to the sample pouch may be stopped prior to completely filling the pouch. For example, in order to target a fill volume of approximately 40 mL, fill to the level indicated by the arrows in Figure 1. Ensure the pouch is hanging vertically. • The tube leading from the Y-junction to the sample pouch contains an additional volume of approximately 2 mL. Precautions: • Do not elevate or squeeze the sample pouch as this could cause blood to backflow from the sample pouch into the collection system. • Once the sample pouch is filled to desired volume, complete steps 10 - 18 within approximately 4 minutes to avoid possible clot formation in the tubing and/or sample pouch. 10. Close the blue clamp on tubing between the Y-junction and the sample pouch. 11. Break the in-line cannula below the Y-junction in the donor tubing to the primary container allowing blood collection to proceed. To completely break the in-line cannula, grasp with both hands. Snap it at a 90° angle in one direction, and then bend it at a 90° angle in the opposite direction. Ensure the in-line cannula is completely broken and that the blood flows freely to the primary container. Precaution: Failure to break the in-line cannula completely may result in restricted blood flow. 12. Following blood center procedures, mix blood and anticoagulant in the primary container immediately and at several intervals during collection. 13. Following blood center procedures, hermetically seal the tubing between the sampling site and the Y-junction to maintain sterility of the blood collection system prior to removing blood samples. Warning: • Do not proceed with the remaining steps until the tubing leading to the sample pouch is hermetically sealed between the sampling site and the Y-junction. To maintain the whole blood collection container as a closed system, the tubing between the sample pouch and Y-junction must be hermetically sealed prior to inserting the access device into the sampling site. Failure to do so may lead to contamination of the whole blood collection. 14. Insert the access device by pushing firmly into the sampling site until the membrane seal is penetrated. Note: If the access device is assembled such that the outer barrel is screwed onto the Luer, make sure to rotate clockwise upon insertion to avoid barrel detaching from Luer. 15. Open the cap on the access device (if applicable). Hold access device so that the sample pouch hangs down. 16. Directly align the vacuum sample tube with the internal needle in the access device. Insert vacuum sample tube into device. 17. Allow vacuum sample tube to fill with blood then remove from the access device. 18. Repeat steps 16 and 17 until the desired number of vacuum sample tubes have been filled. • Notes: • If the access device needs to be replaced, clamp the tubing between the sampling site and the sample pouch. Then, grasp base of sampling site with one hand and pull the access device out with the other hand. Firmly insert the new access device. Remove clamp and continue sampling. • If the access device is assembled such that the outer barrel is screwed onto the Luer, make sure to rotate clockwise upon removal to avoid barrel detaching from Luer. • The access device can only be replaced one time. Precaution: When replacing access device, be careful to avoid contact with any blood droplets on the Luer or sampling site. Discard used access device appropriately. 19. Collect the appropriate volume based on Blood-Pack unit used. Note: The volume of anticoagulant is sufficient for the blood collection indicated on Blood-Pack unit ± 10%. Precaution: Once the desired blood volume is collected, complete steps 20-23 within approximately 4 minutes to avoid possible clot formation in the tubing. 20. Release pressure on the donor’s arm. If appropriate, apply clamp to donor tubing between the needle and the Y-junction. 21. Hermetically seal donor tubing near in-line cannula on side leading to the primary container. 22. Withdrawal of Needle (see Figure 3) Precaution: The needle guard must be held stationary while the needle is withdrawn into it. a) Place folded sterile gauze over puncture site and hold in place with finger tip without exerting pressure. b) Hold sides of needle guard near the front, between the index finger and thumb. Pull the hub back smoothly until the needle is completely enclosed and securely locked into the needle guard. c) Confirm the needle is completely enclosed and securely locked into the needle guard. 23. Strip blood from donor tubing into primary container, mix and allow the tubing to refill; repeat once. 24. Seal at X marks on donor tubing to provide numbered aliquots of anticoagulated blood for typing or crossmatching. Note: Step 25 may be performed prior to step 23 or 24 if desired. 25. Remove and discard the Sample Diversion System and the donor needle in the needle guard into an appropriate biohazardous waste container following established procedures. Component Preparation: Notes: • If a platelet concentrate is to be prepared, it should be separated from the red blood cells within 8 hours after blood collection. • Fresh frozen plasma should be separated from the red blood cells and placed in the freezer at -18° C or colder within 8 hours after blood collection. 26. At the appropriate time, prepare the Blood-Pack unit for centrifugation by thoroughly mixing the primary container end over end, then load the unit in a centrifuge cup per the instructions on Page 3. 27. Following centrifugation, remove containers from the centrifugation cup taking care not to disturb the red blood cell / plasma interface. 28. Place primary container in plasma extractor and express plasma into the appropriate empty Transfer Pack container by releasing pressure plate and opening closure in tubing of primary container. 29. When desired amount of plasma has been removed, clamp tubing between Y and plasma container. 30. Seal transfer tubing in three places between the Y-connector and primary container. Cut middle seal being careful to avoid fluid splatter. 31. For further processing with multiple Blood-Pack units, use standard component processing and storage techniques. 32. Store suspended CPDA-1 Whole Blood/Red Blood Cells between 1 and 6°C. 33. Infuse CPDA-1 Whole Blood/Red Blood Cells within 35 days of collection. Warning: Failure to achieve closed system processing conditions negates the extended storage claim and the red blood cell product must be transfused within 24 hours. Store at Controlled Room Temperature. Protect from freezing. Avoid excessive heat. Definition of “Controlled Room Temperature”: “A temperature maintained thermostatically that encompasses the usual and customary working environment of 20° to 25°C (68° to 77°F); that results in a mean kinetic temperature calculated to be not more than 25°C; and that allows for excursions between 15°C and 30°C (59° and 86°F) that are experienced in pharmacies, hospitals, and warehouses. Provided the mean kinetic temperature remains in the allowed range, transient spikes up to 40°C are permitted as long as they do not exceed 24 hours ... The mean kinetic temperature is a calculated value that may be used as an isothermal storage temperature that simulates the non isothermal effects of storage temperature variations.” Reference: United States Pharmacopeia, General Notices. United States Pharmacopeial Convention, Inc. 12601 Twinbrook Parkway, Rockville, MD. 1 Van der Meer, P.F., & de Korte, D. “Increase of blood donation speed by optimizing the needle-to-tubing connection: an application of donation software.” Vox Sanguinis 2009, 97: 21-25 Sorvall is a trademark of Thermo Fisher Scientific LLC. © 2019 Fresenius Kabi AG. All rights reserved Manufacturer Fresenius Kabi AG 61346 Bad Homburg / Germany www.fresenius-kabi.com 1-800-933-6925 47-23-13-525 REV: A 4r3644image1 4r3644image2 4r3644image3