FDA Adverse Event Other Summary report: N

VENOUS BLOOD LINE PRE & POST PUMP INJ SITE & LVL ADJ

MDR report key: 144603 · Received January 15, 1998

Report

Report Number
1423500-1998-00024
Event Type
Other
Date Received
January 15, 1998
Date of Event
December 1, 1997
Report Date
December 22, 1997
Manufacturer
NMC
Product Code
FJK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

HEALTHCARE PROFESSIONAL (HCP) REPORTS A HOME HELPER CARING FOR THE HOME HEMODIALYSIS PT NOTED MICROBUBBLES IN THE VENOUS LINE BETWEEN THE DRIP CHAMBER AND THE PTS' ACCESS DURING HEMODIALYSIS TREATMENT. THE PT THE COMPLAINED OF A HEADACHE. THE HOME HELPER IMMEDIATELY STOPPED TREATMENT AND CALLED 911. THE PT WAS TRANSFERRED TO THE ER VIA AMBULANCE. THE PT WAS ADMITTED AND AN MRI PERFORMED. NO AIR EMBOLISM NOTED AND HOME PT WAS RELEASED TO HOME THE FOLLOWING DAY. HCP REPORTS SOURCE OF HEADACHE WAS UNDETERMINED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VENOUS BLOOD LINE PRE & POST PUMP INJ SITE & LVL ADJ BLOOD LINE FJK NMC NA NA01

Patients

Seq Age Sex Outcome Treatment
1 * Hospitalization COBE C2 HEMODIALYSIS DEVICE