FDA Adverse Event Other Summary report: N

EXACTA-MIX 2400

MDR report key: 1380599 · Received May 11, 2009

Report

Report Number
1419106-2009-00009
Event Type
Other
Date Received
May 11, 2009
Date of Event
April 7, 2009
Report Date
April 14, 2009
Manufacturer
BAXA CORP.
Product Code
NEP
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
PHARMACIST

Narratives

Additional Manufacturer Narrative · 1

THE CUSTOMER WAS ABLE TO PROVIDE THEIR EM2400 COMPOUNDER DATABASE AND BLACKBOX DATA, AS WELL AS THEIR ABACUS DATABASE AND COPIES OF LABELS PRODUCED BY ABACUS FOR THE SUBJECT BAGS. THE CUSTOMER DID NOT PROVIDE THE PRESCRIBER ORDERS FOR THESE BAGS. AN EVAL OF THE COMPOUNDER MIXCHECK REPORTS AND THE ABACUS SOLUTION LABELS FOR THE SUBJECT BAGS INDICATES THAT THE COMPOUNDER DELIVERED DEXTROSE AS ORDERED IN ABACUS (87.22 ML FOR PT #1, AND 38.43 ML FOR PT #2). IT WAS ALSO DETERMINED THAT THE MIXCHECK REPORT INDICATES THAT THE TOTAL COMPOUNDED VOLUME OF THE SUBJECT BAGS WERE WITHIN +/-3% OF THE ORDERED VOLUME (ACTUAL % DIFFERENCE: -0.51% FOR PT #1, AND -0.66% FOR PT #2). THE INFO PROVIDED BY THE CUSTOMER STATES THAT THE BAG FOR PT #2 HAD A GLUCOSE LEVEL OF 0.5% INSTEAD OF 12.5% ACCORDING TO THE FACILITY LAB RESULTS. THIS WOULD INDICATE A DELIVERY OF 1.535 ML OF DEXTROSE 70% FOR THE ENTIRE BAG, WHICH WOULD BE A TOTAL COMPOUNDED VOLUME OF -11.4% OF THE ORDERED VOLUME. HOWEVER, THE TOTAL WEIGHT DIFFERENCE FOR THIS SUBJECT BAG WAS -0.66%. THE CUSTOMER DID NOT PROVIDE THE LABORATORY TESTS RESULTS. THEREFORE, THE ACCURACY OF THIS FACILITY'S LABORATORY TESTING IS UNK. THE PRUDENT COURSE OF ACTION WOULD BE TO REPEAT THE LABORATORY TEST TO ENSURE THAT THE VALUE WHICH WAS FIRST REPORTED WAS ACCURATE. IF THE MACHINE WERE TO GO OUTSIDE ITS CALIBRATED RANGE, THE ACCURACY DROPS. THE MACHINE USED FOR TESTING THE GLUCOSE CONCENTRATION NEEDS TO BE CABLE OF READING THE RANGE OF COMPLEX TPN SOLUTIONS. THE METHOD USED TO TEST THE RESERVOIR SAMPLES OF THE SUBJECT BAGS WAS NOT PROVIDED. AN EXAMINATION OF THE EM2400 BLACKBOX DATA AND ABACUS DATABASE SHOW NO UNUSUAL EVENTS IN THE DEVICE HISTORY OR INFO THAT MIGHT RELATE TO THE REPORTED INCIDENTS. THROUGH OUR INVESTIGATION, WE DO NOT HAVE INFO SUGGESTING THAT THE EM2400 COMPOUNDER OR ABACUS CALCULATING SOFTWARE CAUSED OR CONTRIBUTED TO THESE INCIDENTS AS A RESULT OF FAILURE, MALFUNCTION, IMPROPER OR INADEQUATE DESIGN, MANUFACTURE, OR LABELING OF THE PRODUCT. A CONFERENCE CALL WAS CONDUCTED ON (B)(4) 2009 WITH THE FACILITY ASST DIRECTOR OF PHARMACY AND BAXA ASSOCIATES TO DISCUSS THE RESULTS OF THE DATA EVAL. TO PREVENT ANY RE-OCCURRING INCIDENTS, ALL PRODUCT MANUFACTURED IN THE FACILITY IV ROOM WILL BE TESTED PRIOR TO USE. IF BAXA RECEIVES ADD'L INFO IN REGARDS TO THIS INCIDENT, A F/U MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

ON (B)(6) 2009, BAXA WAS NOTIFIED BY THE CUSTOMER OF TWO PT INVOLVED INCIDENTS USING THE ABACUS V2.0 TPN CALCULATING SOFTWARE AND THE EXACTA-MIX 2400 COMPOUNDER FOR TPN PRODUCTION. IT WAS REPORTED TO BAXA THAT THIS PT HAD RECEIVED A TPN BAG ON (B)(6) 2009 CONTAINING A LOWER-THAN-ANTICIPATED VOLUME OF THE DEXTROSE INGREDIENT. A SAMPLE FROM THE RESERVOIR WAS SENT TO THE LAB AND THE GLUCOSE LEVEL INDICATED 14.7% INSTEAD OF 17.7%. THE PT'S BLOOD WORK INDICATED THAT THE BLOOD SUGAR LEVELS HAD DROPPED TO 46. DEXTROSE BOLUS WAS ADMINISTERED TO RAISE THE GLUCOSE LEVEL TO 124. THE PT'S CURRENT STATUS IS STABLE WITH NO APPARENT LONG-TERM INJURY OR ILLNESS RESULTING FROM THIS ISSUE.

Additional Manufacturer Narrative · 2

THE CUSTOMER WAS ABLE TO PROVIDE THEIR EM2400 COMPOUNDER DATABASE AND BLACKBOX DATA, AS WELL AS THEIR ABACUS DATABASE AND COPIES OF LABELS PRODUCED BY ABACUS FOR THE SUBJECT BAGS. THE CUSTOMER DID NOT PROVIDE THE PRESCRIBER ORDERS FOR THESE BAGS. AN EVAL OF THE COMPOUNDER MIXCHECK REPORTS AND THE ABACUS SOLUTION LABELS FOR THE SUBJECT BAGS INDICATES THAT THE COMPOUNDER DELIVERED DEXTROSE AS ORDERED IN ABACUS (87.22 ML FOR PT #1, AND 38.43 ML FOR PT #2). IT WAS ALSO DETERMINED THAT THE MIXCHECK REPORT INDICATES THAT THE TOTAL COMPOUNDED VOLUME OF THE SUBJECT BAGS WERE WITHIN +/-3% OF THE ORDERED VOLUME (ACTUAL % DIFFERENCE: -0.51% FOR PT #1, AND -0.66% FOR PT #2). THE INFO PROVIDED BY THE CUSTOMER STATES THAT THE BAG FOR PT #2 HAD A GLUCOSE LEVEL OF 0.5% INSTEAD OF 12.5% ACCORDING TO THE FACILITY LAB RESULTS. THIS WOULD INDICATE A DELIVERY OF 1.535 ML OF DEXTROSE 70% FOR THE ENTIRE BAG, WHICH WOULD BE A TOTAL COMPOUNDED VOLUME OF -11.4% OF THE ORDERED VOLUME. HOWEVER, THE TOTAL WEIGHT DIFFERENCE FOR THIS SUBJECT BAG WAS -0.66%. THE CUSTOMER DID NOT PROVIDE THE LABORATORY TESTS RESULTS. THEREFORE, THE ACCURACY OF THIS FACILITY'S LABORATORY TESTING IS UNK. THE PRUDENT COURSE OF ACTION WOULD BE TO REPEAT THE LABORATORY TEST TO ENSURE THAT THE VALUE WHICH WAS FIRST REPORTED WAS ACCURATE. IF THE MACHINE WERE TO GO OUTSIDE ITS CALIBRATED RANGE, THE ACCURACY DROPS. THE MACHINE USED FOR TESTING THE GLUCOSE CONCENTRATION NEEDS TO BE CABLE OF READING THE RANGE OF COMPLEX TPN SOLUTIONS. THE METHOD USED TO TEST THE RESERVOIR SAMPLES OF THE SUBJECT BAGS WAS NOT PROVIDED. AN EXAMINATION OF THE EM2400 BLACKBOX DATA AND ABACUS DATABASE SHOW NO UNUSUAL EVENTS IN THE DEVICE HISTORY OR INFO THAT MIGHT RELATE TO THE REPORTED INCIDENTS. THROUGH OUR INVESTIGATION, WE DO NOT HAVE INFO SUGGESTING THAT THE EM2400 COMPOUNDER OR ABACUS CALCULATING SOFTWARE CAUSED OR CONTRIBUTED TO THESE INCIDENTS AS A RESULT OF FAILURE, MALFUNCTION, IMPROPER OR INADEQUATE DESIGN, MANUFACTURE, OR LABELING OF THE PRODUCT. A CONFERENCE CALL WAS CONDUCTED ON (B)(4) 2009 WITH THE FACILITY ASST DIRECTOR OF PHARMACY AND BAXA ASSOCIATES TO DISCUSS THE RESULTS OF THE DATA EVAL. TO PREVENT ANY RE-OCCURRING INCIDENTS, ALL PRODUCT MANUFACTURED IN THE FACILITY IV ROOM WILL BE TESTED PRIOR TO USE. IF BAXA RECEIVES ADD'L INFO IN REGARDS TO THIS INCIDENT, A F/U MDR WILL BE SUBMITTED.

Description of Event or Problem · 2

ON (B)(6) 2009, BAXA WAS NOTIFIED BY THE CUSTOMER OF TWO PT INVOLVED INCIDENTS USING THE ABACUS V2.0 TPN CALCULATING SOFTWARE AND THE EXACTA-MIX 2400 COMPOUNDER FOR TPN PRODUCTION. IT WAS REPORTED TO BAXA THAT THIS PT HAD RECEIVED A TPN BAG ON (B)(6) 2009 CONTAINING A LOWER-THAN-ANTICIPATED VOLUME OF THE DEXTROSE INGREDIENT. A SAMPLE FROM THE RESERVOIR WAS SENT TO THE LAB AND THE GLUCOSE LEVEL INDICATED 14.7% INSTEAD OF 17.7%. THE PT'S BLOOD WORK INDICATED THAT THE BLOOD SUGAR LEVELS HAD DROPPED TO 46. DEXTROSE BOLUS WAS ADMINISTERED TO RAISE THE GLUCOSE LEVEL TO 124. THE PT'S CURRENT STATUS IS STABLE WITH NO APPARENT LONG-TERM INJURY OR ILLNESS RESULTING FROM THIS ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EXACTA-MIX 2400 EXACTA-MIX 2400 NEP BAXA CORP. EM 2400 NA

Patients

Seq Age Sex Outcome Treatment
1 10 DA Required Intervention
2 1 DA Required Intervention