FDA Adverse Event Injury Summary report: N

HEMOLUNG RAS

MDR report key: 16179758 · Received January 16, 2023

Report

Report Number
3009763347-2023-00018
Event Type
Injury
Date Received
January 16, 2023
Date of Event
December 6, 2017
Report Date
January 16, 2023
Manufacturer
ALUNG TECHNOLOGIES, INC
Product Code
DQR
PMA / PMN Number
DEN210006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PATIENT INFORMATION WAS NOT PROVIDED. LOT/SERIAL NUMBER WAS NOT PROVIDED, SO THE UDI AND EXPIRATION DATE COULD NOT BE DETERMINED. AS LOT NUMBER WAS NOT PROVIDED, MANUFACTURING DATE COULD NOT BE DETERMINED. ALUNG TECHNOLOGIES, INC. MANUFACTURES THE HEMOLUNG RAS AND CATHETER. THE INCIDENT OCCURRED IN TRURO, UNITED KINGDOM. THROUGH REVIEW OF THE FINAL CLINICAL STUDY ADVERSE EVENT LISTINGS, IT WAS REPORTED THAT A PATIENT EXPERIENCED THROMBOEMBOLISM, VENOUS EVENT OR VASCULAR OBSTRUCTION OF HEMOLUNG CATHETER. AS NO FURTHER NOTIFICATION WAS RECEIVED REGARDING THIS ADVERSE EVENT, NO FURTHER INFORMATION IS AVAILABLE. NO CAPA WAS OPENED BECAUSE OF THIS EVENT. THROMBOEMBOLISM, CATHETER CLOTTING IS A KNOWN POTENTIAL COMPLICATION THAT CAN OCCUR DURING EXTRACORPOREAL THERAPY. ALUNG TECHNOLOGIES, INC. WILL CONTINUE TO MONITOR ANY ISSUES AS THEY ARE REPORTED. THIS MDR IS BEING FILED IN RESPONSE TO A RETROSPECTIVE VIEW OF ALL ALUNG TECHNOLOGIES, INC. 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 OF A PATIENT EXPERIENCING A DISLOGED BLOOD CLOT, VENOUS EVENT, OR VASCULAR OBSTRUCTION OF THE HEMOLUNG CATHETER DURING HEMOLUNG THERAPY. THE EVENT RESULTED IN NON-ELECTIVE THERAPY CESSATION. NO FURTHER INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
750516 HEMOLUNG RAS CANNULA, CATHETER DQR ALUNG TECHNOLOGIES, INC

Patients

Seq Age Sex Outcome Treatment
1 Female Other