FDA Adverse Event Malfunction Summary report: N

ISPAN PERFLUOROPROPANE (C3F8) GAS

MDR report key: 1476273 · Received July 2, 2009

Report

Report Number
2518435-2009-00005
Event Type
Malfunction
Date Received
July 2, 2009
Date of Event
May 20, 2009
Report Date
June 26, 2009
Manufacturer
AIR LIQUIDE HEALTHCARE AMERICA CORPORATION
Product Code
LPO
PMA / PMN Number
P900066
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION SUMMARY: THE PRODUCT WAS NOT RETURNED FOR EVALUATION. THERE HAVE BEEN NO OTHER REPORTS INVOLVING THIS LOT NUMBER. (B) (4).

Description of Event or Problem · 1

A FACILITY REPORTED THE PRODUCT DID NOT LAST AS LONG AS ANTICIPATED WHEN IT WAS USED ON A PATIENT DURING VITREOUS-RETINAL SURGERY. AN ADDITIONAL SURGICAL PROCEDURE WAS PERFORMED APPROXIMATELY TWO AND A HALF WEEKS LATER TO REPLACE THE PRODUCT. THE SURGEON REPORTED THE PATIENT IS EXPECTED TO RECOVER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ISPAN PERFLUOROPROPANE (C3F8) GAS PRODUCT CODE LPO/INTRAOCULAR GAS LPO AIR LIQUIDE HEALTHCARE AMERICA CORPORATION C3F8, 125 G 722715

Patients

Seq Age Sex Outcome Treatment
1 69 YR