FDA Adverse Event Injury Summary report: N

HEMOLUNG RAS

MDR report key: 16211978 · Received January 19, 2023

Report

Report Number
3009763347-2023-00110
Event Type
Injury
Date Received
January 19, 2023
Date of Event
January 15, 2020
Report Date
January 19, 2023
Manufacturer
ALUNG TECHNOLOGIES, INC.
Product Code
QOH
UDI-DI
00850046004346
PMA / PMN Number
DEN210006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PATIENT INFORMATION WAS NOT PROVIDED. ALUNG TECHNOLOGIES, INC. MANUFACTURES THE HEMOLUNG RAS AND CATHETER. THE INCIDENT OCCURRED IN (B)(4). IT WAS REPORTED THAT THE PATIENT EXPERIENCED CHRONIC NORMOCYTIC ANEMIA DURING HEMOLUNG THERAPY. THE PATIENT'S HEMOGLOBIN HAD BEEN GRADUALLY DOWN TRENDING DURING ADMISSION WITHOUT ACUTE DROP. 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 POTENTIAL COMPLICATIONS ASSOCIATED WITH USE OF EXTRACORPOREAL THERAPY. REVIEW OF THE 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 THAT A PATIENT EXPERIENCED ANEMIA DURING HEMOLUNG THERAPY. MEDICATION WAS REQUIRED, BUT HEMOLUNG THERAPY CONTINUED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
406013 HEMOLUNG RAS EXTRACORPOREAL SYSTEM FOR CARBON DIOXIDE REMOVAL QOH ALUNG TECHNOLOGIES, INC. HL-CR4-01-000 00850046004346

Patients

Seq Age Sex Outcome Treatment
1 Unknown Life Threatening| R