FDA Adverse Event Death Summary report: N

HEMOCHRON MICROCOAGULATION SYSTEM

MDR report key: 1205878 · Received October 20, 2008

Report

Report Number
2248721-2008-00019
Event Type
Death
Date Received
October 20, 2008
Date of Event
September 24, 2008
Report Date
October 20, 2008
Manufacturer
INTERNATIONAL TECHNIDYNE CORPORATION
Product Code
JBP
PMA / PMN Number
K960749
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURER EVALUATION / INVESTIGATION CURRENTLY IN PROCESS.

Description of Event or Problem · 1

DEVICE 2 OF 2 - CUSTOMER REPORTS 4 CRITICALLY ILL PEDATRIC ECMO PATIENTS EXPIRED OVER AN UNSPECIFIED SIX WEEK PERIOD. DURING TREATMENT, CLOTTING TIME WAS MEASURED USING HEMOCHRON ACT-LR / SIGNATURE ELITE INSTRUMENTS. AS 2 SIGNATURE ELITE INSTRUMENTS ARE IN USE, CUSTOMER IS UNABLE TO IDENTIFY WHICH INSTRUMENT USED WITH SPECIFIC PATIENTS. CUSTOMER REVIEWING MEDICATION REGIMEN FOR CAUSALITY. THIS REPORT IS FOR DEVICE 2 OF 2.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEMOCHRON MICROCOAGULATION SYSTEM ACT-LR ASSAY / SIGNATURE ELITE INSTRUMENT JBP INTERNATIONAL TECHNIDYNE CORPORATION SIGNATURE ELITE ACT-LR-UNAVAILABLE

Patients

Seq Age Sex Outcome Treatment
1 2 YR Death