FDA Adverse Event Injury Summary report: N

HEMOLUNG RAS

MDR report key: 16164954 · Received January 13, 2023

Report

Report Number
3009763347-2023-00005
Event Type
Injury
Date Received
January 13, 2023
Date of Event
May 8, 2020
Report Date
January 13, 2023
Manufacturer
ALUNG TECHNOLOGIES, INC.
Product Code
QLN
UDI-DI
00850046004346
PMA / PMN Number
DEN210006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PATIENT IDENTIFIER, WEIGHT, ETHNICITY, RACE: THIS PATIENT INFORMATION WAS NOT PROVIDED. ALUNG TECHNOLOGIES, INC. MANUFACTURES THE HEMOLUNG RAS AND CATHETER. THE INCIDENT OCCURRED IN (B)(4). MEDICAL INTERVENTION WAS REQUIRED TO PREVENT FURTHER PATIENT INJURY. THROUGH REVIEW OF THE EXPANDED ACCESS FORM, THE PATIENT EXPERIENCED A PNEUMOTHORAX. THE SITE COORDINATOR HAD ALSO AT THE TIME OF OCCURRENCE NOTIFIED ALUNG OF THE DETERIORATION OF THE PATIENT. DESPITE ADEQUATE ANTICOAGULATION, THE PATIENT EXPERIENCED A PULMONARY EMBOLISM, RIGHT HEART FAILURE, HYPOXEMIA WITH HEMODYNAMIC INSTABILITY, AND PNEUMOTHORAX REQUIRING CHEST TUBE. THE FAMILY INSTITUTED A DNR STATUS ON THE PATIENT, BUT AT THE TIME OF THE DETERIORATION OF THE PATIENT, THE HEMOLUNG WAS STILL PROVIDING ADEQUATE SUPPORT FOR THE PATIENT. THE DATA LOG FROM THERAPY HAS BEEN RETRIEVED AND REVIEWED BY BOTH CLINICAL AND SOFTWARE ENGINEERING STAFF. NO ABNORMALITIES WERE NOTED WITHIN THE CO2 REMOVAL AND BLOOD FLOW GRAPHS. NO UNEXPECTED ALARMS OR CRITICAL ERRORS OCCURRED. THERAPY WAS PROVIDED AS INTENDED. PNEUMOTHORAX IS A KNOWN COMPLICATION THAT CAN OCCUR DURING EXTRACORPOREAL THERAPY. THERE IS NO INDICATION OF ANY RELATION TO HEMOLUNG THERAPY. EXAMINATION OF THE CONTROLLER DATA LOG SHOWS THAT THERAPY WAS PROVIDED AS INTENDED. ALUNG WILL CONTINUE TO MONITOR ANY ISSUES AS THEY ARE REPORTED. THIS MDR IS BEING FILED IN RESPONSE TO A RETROSPECTIVE VIEW OF ALL ALUNG COMPLAINTS, WHICH IDENTIFIED THAT THE REPORTING DECISION FOR THIS COMPLAINT WAS NOT CORRECT. THIS MDR IS BEING FILED RETROSPECTIVELY TO CORRECT THE ERROR IN THE REPORTING DECISION.

Description of Event or Problem · 0

ALUNG TECHNOLOGIES, INC. RECEIVED A REPORT THAT DURING HEMOLUNG EUA THERAPY A PATIENT EXPERIENCED PNEUMOTHORAX AND A CHEST TUBE WAS PLACED. HEMOLUNG EUA THERAPY WAS NOT DISCONTINUED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1132983 HEMOLUNG RAS EXTRACORPOREAL SYSTEM FOR CARBON DIOXIDE REMOVAL FOR THE TREATMENT OF COVID-19 QLN ALUNG TECHNOLOGIES, INC. HL-CR4-01-000 00850046004346

Patients

Seq Age Sex Outcome Treatment
1 49 YR Male Life Threatening| R