BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HEMOLUNG RAS

    MDR report key: 16179788 · Received January 16, 2023

    Report

    Report Number
    3009763347-2023-00025
    Event Type
    Injury
    Date Received
    January 16, 2023
    Date of Event
    June 15, 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

    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 (B)(6). THROUGH REVIEW OF THE FINAL CLINICAL STUDY ADVERSE EVENT LISTINGS, IT WAS REPORTED THAT A PATIENT EXPERIENCED AN ADVERSE EVENT IN WHICH THE HEMOLUNG ACCESS CATHETER BECAME DISLODGED DURING DIRECT PATIENT CARE. AS NO FURTHER NOTIFICATION WAS RECEIVED REGARDING THIS ADVERSE EVENT, NO FURTHER INFORMATION IS AVAILABLE. NO CAPA WAS OPENED BECAUSE OF THIS EVENT. ANY INSERTED CATHETERS, NOT SPECIFIC TO THE HEMOLUNG CATHETER, HAVE THE POTENTIAL RISK OF BECOMING DISLODGED DURING DIRECT PATIENT CARE. 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 THAT THE HEMOLUNG ACCESS CATHETER BECAME DISLODGED DURING DIRECT PATIENT CARE. NO FURTHER INFORMATION WAS PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    751501 HEMOLUNG RAS CANNULA, CATHETER DQR ALUNG TECHNOLOGIES, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Unknown Other