FDA Adverse Event Injury Summary report: N

HEMOLUNG RAS

MDR report key: 16211822 · Received January 19, 2023

Report

Report Number
3009763347-2023-00076
Event Type
Injury
Date Received
January 19, 2023
Date of Event
October 1, 2020
Report Date
January 19, 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

THIS PATIENT INFORMATION WAS NOT PROVIDED. ALUNG TECHNOLOGIES, INC. MANUFACTURES THE HEMOLUNG RAS AND CATHETER. THE INCIDENT OCCURRED IN (B)(6). MEDICAL INTERVENTION WAS NECESSARY TO AVOID FURTHER PATIENT INJURY. THROUGH REVIEW OF THE EXPANDED ACCESS FORM, THE PATIENT EXPERIENCED ANEMIA. IT WAS NOTED THAT THE PATIENT RECEIVED EIGHT UNITS OF BLOOD, 2 UNITS THAWED PLASMA, AND 2 UNITS PLT. THERAPY WAS NOT DISCONTINUED AS A RESULT OF THIS ISSUE. 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. THERAPY WAS PROVIDED AS INTENDED. NO CAPA WAS OPENED BECAUSE OF THIS EVENT. ANEMIA IS A KNOWN COMPLICATION THAT CAN OCCUR DURING EXTRACORPOREAL THERAPY. EXAMINATION OF THE CONTROLLER DATA LOG SHOWS THAT THERAPY WAS PROVIDED AS INTENDED. 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 ANEMIA, BOTH SEVERE AND ACUTE DURING EUA HEMOLUNG THERAPY. EIGHT UNITS OF BLOOD, 2 UNITS OF PLASMA, AND 2 UNITS OF PLT WERE PROVIDED TO THE PATIENT OVER 3 DAYS. HEMOLUNG THERAPY WAS NOT DISCONTINUED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
363319 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 76 YR Male Required Intervention| L