FDA Adverse Event Other Summary report: N

HEMOCHRON SIGNATURE INSTRUMENT /ACT-LA ASSAY

MDR report key: 1312408 · Received February 10, 2009

Report

Report Number
2248721-2009-00041
Event Type
Other
Date Received
February 10, 2009
Report Date
February 10, 2009
Manufacturer
INTERNATIONAL TECHNIDYNE CORP.
Product Code
JBP
PMA / PMN Number
K960749
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). DUE TO RECENT RECEIPT OF INFO BY ITC CLARIFYING REPORTING RULES WHERE BOTH MULTIPLE PTS AND MULTIPLE DEVICES ARE INVOLVED. IN ACCORDANCE WITH THAT INFO, THIS F/U REPORT CLARIFIES THE PT - ADVERSE EVENT RELATIONSHIP AS OPPOSED TO PRIOR REPORTS WHICH NOTED THE DEVICE - ADVERSE EVENT RELATIONSHIP. IN A TELECONFERENCE WITH THE MEDICAL DIRECTOR ON 04/30/2008, THE MEDICAL DIRECTOR CONCLUDED THAT FACILITY WILL NOT RETURN PRODUCT FOR ITC EVAL AS: CORRELATION STUDIES PERFORMED BY THE FACILITY SHOW ACCEPTABLE PERFORMANCE OF THE SUBJECT HEMOCHRON SYSTEM. HEMOCHRON SYSTEMS IN PLACE AT OTHER AREAS OF THE HOSPITAL ARE PERFORMING WELL. FACILITY BELIEVES THE SUBJECT HEMOCHRON SYSTEM IS OPERATING CORRECTLY. THE SUBJECT HEMOCHRON SYSTEM CONTINUES TO BE USED WITHOUT ISSUE IN FACILITY. WHILE NOT PROVEN TO BE DIRECTLY CORRELATED TO THE SUBJECT EVENTS, PPT DRUG TREATMENT THERAPY FOR NEONATES ON ECMO WITH DIAPHRAGMATIC HERNIAS HAS BEEN ALTERED. FACILITY HAS BEEN REQUESTED TO PROVIDE IN-HOUSE CORRELATION STUDY DATA TO MFR.

Description of Event or Problem · 1

OVER APPROX 12 MONTHS PERIOD, 6 PTS IN FACILITY NEONATE UNIT EXPERIENCED CRANIAL BLEED FOR UNDETERMINED REASONS. PTS ARE CATEGORIZED BY FACILITY AS HIGH-RISK, ON ECMO, WITH DIAPHRAGMATIC HERNIAS. FACILITY INVESTIGATION CONCLUDED HEMOCHRON SIGNATURE/ACT-LR SYSTEM NOT CAUSAL AND HAS ALTERED DRUG TREATMENT THERAPY PRACTICES. THIS REPORT IS FOR PT 5 OF 6.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEMOCHRON SIGNATURE INSTRUMENT /ACT-LA ASSAY HEMOCHRON SIGNATURE ACT-LR JBP INTERNATIONAL TECHNIDYNE CORP. HE-SIG ASSAY/UNAVAILABLE

Patients

Seq Age Sex Outcome Treatment
1 UNK Other