FDA Adverse Event Injury Summary report: N

TUBING SET

MDR report key: 16960295 · Received May 19, 2023

Report

Report Number
8010762-2023-00219
Event Type
Injury
Date Received
May 19, 2023
Date of Event
March 29, 2023
Report Date
June 15, 2023
Manufacturer
MAQUET CARDIOPULMONARY GMBH
Product Code
DTZ
PMA / PMN Number
K112360
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE.

Additional Manufacturer Narrative · 0

MAQUET CARDIOPULMONARY GMBH HAS RECEIVED THE FOLLOWING INFORMATION FROM THE SPANISH AGENCY OF MEDICINES AND MEDICAL DEVICE ON 2023-05-12: THE VIGILANCE AREA OF MEDICAL DEVICES OF THE SPANISH AGENCY OF MEDICINES AND MEDICAL DEVICES HAS BEEN INFORMED THROUGH RENACER REGISTRY ABOUT AN INCIDENT INVOLVING THE PRODUCT ¿CARDIOHELP SYSTEM¿, MANUFACTURED BY GETINGE AND DISTRIBUTED BY, OCCURRED ON 2023-03-29. THE INFORMATION WAS PROVIDED THAT THE PATIENT SUFFERED AN EDEMATIZATION OF THE RIGHT LOWER EXTREMITY ASSOCIATED WITH AN INTRAMUSCULAR HEMATOMA. ON 20223-06-06 THE CUSTOMER CONFIRMED THAT NEITHER THE CARDIOHELP, HLS SET, NOR THE HLS CANNULAS ARE INVOLVED IN THE EVENT. BASED ON THE AVAILABLE INFORMATION THE REPORTED EVENT " PATIENT SUFFERED AN EDEMATIZATION OF THE RIGHT LOWER EXTREMITY ASSOCIATED WITH AN INTRAMUSCULAR HEMATOMA" COULD BE CONFIRMED, BUT WAS NOT RELATED TO A DEVICE MALFUNCTION. THIS COMPLAINT WAS FOUND IN THE DATABASE OF CUSTOMER COMPLAINTS AS A SINGLE EVENT (TIMEFRAME FROM 2022-03-21 TILL 2023-03-21). THE CUSTOMER WILL BE INFORMED ABOUT THE RESULTS BY THE GETINGE SALES AND SERVICE UNIT. THE OCCURRENCE RATE RELATED TO THE REPORTED ISSUE IS CURRENTLY BEING MONITORED AS PART OF MAQUET CARDIOPULMONARY¿ S TRENDING PROGRAM AND ADDITIONAL INVESTIGATIONS OR CORRECTIONS WILL BE IMPLEMENTED IN CASE OF ADVERSE TRENDING. H3 OTHER TEXT : HLS SET WAS DISCARDED BY CUSTOMER.

Description of Event or Problem · 0

MAQUET CARDIOPULMONARY GMBH HAS RECEIVED THE FOLLOWING INFORMATION FROM THE SPANISH AGENCY OF MEDICINES AND MEDICAL DEVICE ON (B)(6) 2023: THE VIGILANCE AREA OF MEDICAL DEVICES OF THE SPANISH AGENCY OF MEDICINES AND MEDICAL DEVICES HAS BEEN INFORMED THROUGH RENACER REGISTRY ABOUT AN INCIDENT INVOLVING THE PRODUCT ¿CARDIOHELP SYSTEM¿, MANUFACTURED BY GETINGE AND DISTRIBUTED BY, OCCURRED ON (B)(6) 2023. THE INFORMATION WAS PROVIDED THAT THE PATIENT SUFFERED AN EDEMATIZATION OF THE RIGHT LOWER EXTREMITY ASSOCIATED WITH AN INTRAMUSCULAR HEMATOMA." COMPLAINT ID (B)(4).

Description of Event or Problem · 0

COMPLAINT ID# (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
874141 TUBING SET OXYGENATOR, CARDIOPULMONARY BYPASS DTZ MAQUET CARDIOPULMONARY GMBH BE-HLS 7050 #SHLS SET ADVANCED 7.0 3000239766

Patients

Seq Age Sex Outcome Treatment
1 Unknown Life Threatening