FDA Adverse Event Malfunction Summary report: N

CADD

MDR report key: 11904472 · Received May 28, 2021

Report

Report Number
3012307300-2021-05142
Event Type
Malfunction
Date Received
May 28, 2021
Date of Event
April 6, 2021
Report Date
May 28, 2021
Product Code
FPA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

INFORMATION WAS RECEIVED REGARDING A CADD ADMINISTRATION SET. IT WAS REPORTED THAT PATIENT WAS HOSPITALIZED FROM (B)(6) 2021 THROUGH (B)(6) 2021 DUE TO A HICKMAN LINE INFECTION. PATIENT ALSO CAUGHT COVID-19 WHILE BEING HOSPITALIZED. DURING REPORT, PATIENT HAD BLOOD IN LINE AND THE PUMP TUBING WAS ALARMING HIGH PRESSURE WHEN HE TRIED TO FIX IT ON HIS OWN. PATIENT HAD NO REMODULIN INFUSION FOR ABOUT THREE TO FOUR HOURS. HE DENIED ANY SYMPTOMS. THE PUMP WAS LATER INFUSION AND THERE WAS NO MORE BLOOD IN THE TUBING; THE ALARM RESOLVED. (REMODULIN 5MG/ML, DOSE AND ROUTE PRESCRIBED: REMODULIN DOSE - 80 NG/KG/ M I N - INTRAVENOUS).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
801825 CADD INTRAVASCULAR ADMINISTRATION SET FPA

Patients

Seq Age Sex Outcome Treatment
1 54 YR