FDA Adverse Event Death Summary report: N

PCS2 PLASMA COLLECTION SYSTEM

MDR report key: 10881256 · Received November 21, 2020

Report

Report Number
1219343-2020-00114
Event Type
Death
Date Received
November 21, 2020
Date of Event
October 23, 2020
Report Date
October 26, 2020
Manufacturer
HAEMONETICS CORPORATION
Product Code
GKT
UDI-DI
30812747011900
PMA / PMN Number
BK060033
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 1

HAEMONETICS SENT A FIELD SERVICE ENGINEER TO EVALUATE THE PCS®2 PLASMA COLLECTION SYSTEM IN ORDER TO CHECK FOR ANY FAULTS, THE MACHINE WAS FOUND TO MEET SPECIFICATIONS AND DID NOT HAVE ANY DEFECTS WHICH REQUIRED REPAIR. THERE WAS NO EVIDENCE OF A DEVICE MALFUNCTION FOUND.

Description of Event or Problem · 1

ON OCTOBER 26 2020, HAEMONETICS WAS NOTIFIED OF A DONOR FATALITY WHICH HAD OCCURRED WITHIN 24 HOURS OF THE DONOR'S LAST PLASMA DONATION PROCEDURE, UTILIZING THE PCS®2 PLASMA COLLECTION SYSTEM. THE PLASMA COLLECTION PROCEDURE WAS COMPLETED SUCCESSFULLY, NO COMPLICATIONS REPORTED. THE PCS®2 PLASMA COLLECTION SYSTEM COLLECTED 878ML PLASMA AND RETURNED 500ML OF SALINE PER THE ROUTINE PROCEDURE. THE DONOR HAD COMPLETED 171 PREVIOUS DONATIONS WITHOUT ANY ISSUES OR REACTIONS RECORDED. BASED ON VIDEO THE CENTER OBSERVED NOTHING OUT OF THE ORDINARY DURING THE DONATION OR WHEN DONOR LEFT THE CENTER. HAEMONETICS WAS NOTIFIED THAT AN AUTOPSY WAS PERFORMED BUT AT THIS TIME CAUSE OF DEATH WAS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1346258 PCS2 PLASMA COLLECTION SYSTEM PCS2,LIST NO. 06002-CP-110 GKT HAEMONETICS CORPORATION 06002-CP-110 30812747011900

Patients

Seq Age Sex Outcome Treatment
1 24 YR Death