FDA Adverse Event Summary report: N

SYSTEM ONE

MDR report key: 1013009 · Received March 6, 2008

Report

Report Number
1013009
Date Received
March 6, 2008
Date of Event
September 27, 2007
Report Date
March 6, 2008
Manufacturer
NXSTAGE MEDICAL, INC.
Product Code
KDI
Report Source
User Facility report
Reporter Location
TX, US
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

THE DIALYSIS MACHINE ALARMED INDICATING AN OVERHEATED DIALYSATE ERROR. ALARM WOULD NOT CLEAR; TREATMENT TERMINATED. THE BIOMEDICAL TESTING CONCLUDED THAT THE DIALYSATE FLUID WAS TOO HOT AND CAUSED THE MACHINE TO ALARM. THE ALARM THAT WOULD NOT CLEAR MAY HAVE BEEN DUE TO THE WARM ROOM TEMPERATURE COMBINED WITH THE EFFECT OF A NEARBY HEATING LAMP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYSTEM ONE HEMODIALYSIS MACHINE KDI NXSTAGE MEDICAL, INC. SYSTEM ONE *

Patients

Seq Age Sex Outcome Treatment
1 23 YR