FDA Adverse Event Malfunction Summary report: N

NXSTAGE SYSTEM ONE

MDR report key: 1589652 · Received January 20, 2010

Report

Report Number
3003464075-2010-00007
Event Type
Malfunction
Date Received
January 20, 2010
Date of Event
December 23, 2009
Report Date
December 23, 2009
Manufacturer
NXSTAGE MEDICAL, INC.
Product Code
KDI
PMA / PMN Number
K050525
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DISPOSABLE CARTRIDGE WAS NOT RETURNED FOR EVAL AS REQUESTED. THE REPORTED EVENT CANNOT BE CONFIRMED. THE USER'S GUIDE CONTAINS PROBABLE CAUSES FOR ALARMS AND ADEQUATE INSTRUCTIONS FOR ALARM RECOVERY. A REVIEW OF THE REPORTED LOT NUMBER FOUND NO OTHER SIMILAR COMPLAINTS REPORTED. NXSTAGE MEDICAL CONSIDERS THIS REPORT CLOSED. NO ADDITIONAL INFO WILL BE PROVIDED.

Description of Event or Problem · 1

A VENOUS PRESSURE LOW ALARM OCCURRED DURING A ROUTINE HEMODIALYSIS TREATMENT. THE OPERATOR NOTED BLOOD LEAKING WHERE THE ARTERIAL BLOOD TUBING CONNECTS TO THE DIALYZER AND IMMEDIATELY ENDED TREATMENT WITHOUT PERFORMING RINSEBACK, RESULTING IN AN ESTIMATED BLOOD LOSS OF 190CC. NO MEDICAL INTERVENTION WAS REQUIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NXSTAGE SYSTEM ONE HIGH PERMEABILITY HEMODIALYSIS SYSTEM KDI NXSTAGE MEDICAL, INC. CAR-170-B 9107715

Patients

Seq Age Sex Outcome Treatment
1 36 YR