FDA Adverse Event Other Summary report: N

MAIN PUMP TUBING

MDR report key: 1001412 · Received February 20, 2008

Report

Report Number
1220246-2008-00011
Event Type
Other
Date Received
February 20, 2008
Date of Event
January 16, 2008
Report Date
January 21, 2008
Manufacturer
ARTHREX, INC.
Product Code
HRX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED AND EVALUATION IS IN PROGRESS. A FOLLOW UP REPORT WILL BE SUBMITTED UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 1

IT WAS REPORTED THAT AFTER 8 MINS INTO A SHOULDER REPAIR, THE PT'S SHOULDER BECAME DISTENDED. THE SHOULDER CONTINUED TO GET BIGGER THROUGHOUT THE CASE. THE SURGEON HAD STARTED THE CASE WITH PUMP SETTINGS AT 40MMHG AND 70% FLOW. THE PUMP WAS TURNED DOWN TO 20MMHG AND 70% FLOW. BLISTERS WERE REPORTED AROUND THE PORTAL SITES FROM THE CANNULAS AGAINST THE SKIN. THE SURGERY WAS DELAYED OVER 30 MINS. FURTHER COMMUNICATION INDICATES THE BLISTERS HAVE RESOLVED AND THE PT IS IN GOOD CONDITION. NO FURTHER PT INFO WAS PROVIDED. THIS DEVICE IS USED FOR TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MAIN PUMP TUBING TUBING SYSTEM HRX ARTHREX, INC. NA 003265

Patients

Seq Age Sex Outcome Treatment
1 UNK Other AR-6400/ UNK SN