BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TR BAND RADIAL COMPRESSION DEVICE

    MDR report key: 17172117 · Received June 21, 2023

    Report

    Report Number
    1118880-2023-00213
    Event Type
    Malfunction
    Date Received
    June 21, 2023
    Date of Event
    May 15, 2023
    Report Date
    June 21, 2023
    Manufacturer
    TERUMO MEDICAL CORPORATION
    Product Code
    DXC
    PMA / PMN Number
    K213531
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    THE ACTUAL DEVICE WAS NOT RETURNED; THEREFORE, AN EVALUATION OF THE ACTUAL DEVICE WAS UNABLE TO BE CONDUCTED. THE COMPLAINT CANNOT BE CONFIRMED FOR POSITIONING ISSUES OF THE TR BAND 2 BECAUSE THE SAMPLE WAS NOT RETURNED FOR ASSESSMENT. WITHOUT A SAMPLE, THE EXACT ROOT CAUSE CANNOT BE DETERMINED. IT IS POSSIBLE THE USER IS NOT APPLYING THE BAND CORRECTLY INITIALLY, LEADING TO SLIPPING ON THE WRIST. REVIEW OF THE DEVICE HISTORY RECORD (DHR) COULD NOT BE COMPLETED DUE TO THE UNKNOWN LOT NUMBER. CURRENTLY NO ACTION IS RECOMMENDED SINCE THIS RISK EVALUATION IS WITHIN THE PREDETERMINED LIMITS IN THE HAZARD BASED RISK TABLE (HBRT).

    Additional Manufacturer Narrative · 0

    D4: LOT NUMBER: REQUESTED, UNKNOWN. D4: EXPIRATION DATE: UNKNOWN DUE TO UNKNOWN LOT NUMBER . D4: UDI: UNKNOWN DUE TO UNKNOWN LOT NUMBER. D6A: IMPLANTED DATE: DEVICE WAS NOT IMPLANTED. D6B: EXPLANTED DATE: DEVICE WAS NOT EXPLANTED. E3: OCCUPATION: LEAD TECH. H4: DEVICE MANUFACTURE DATE: UNKNOWN DUE TO UNKNOWN LOT NUMBER. THE PRODUCTION LOT NUMBER WAS NOT PROVIDED BY THE USER FACILITY, WHICH PREVENTED A MEANINGFUL REVIEW OF THE DEVICE HISTORY RECORD. THE ACTUAL DEVICE WAS NOT RETURNED FOR EVEALUATION. THE INVESTIGATION IS CURRENTLY ONGOING. A FOLLOW UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.

    Description of Event or Problem · 0

    THE USER FACILITY REPORTED THAT THE TR BAND 2 SLIPPED WHEN APPLIED AFTER REMOVING THE RADIAL SHEATH. THE CUSTOMER STATED THAT IF THE BAND SLIPS FROM ITS DESIRED LOCATION IT WILL LIKELY LEAD TO A LATE BLEED. THEY ALSO COMMENTED THAT THE PLASTIC MATERIAL ON THE TR BAND 2 IS SLIPPERY COMPARED TO THE TR BAND 1. THE CUSTOMER ALSO STATED THAT MOVING FORWARD THEY HAVE BEEN EXTRA CAREFUL TO BE SURE THE SKIN IS EXTRA DRY BEFORE APPLYING THE TR BAND 2. THE PATIENT WAS IN STABLE CONDITION. THE PROCEDURE WAS SUCCESSFUL. NO PATIENT INJURY OR MEDICAL INTERVENTION REQUIRED. ADDITIONAL INFORMATION WAS RECEIVED ON 31 MAY 2023: THEY DID NOT HAVE ANY ISSUES OR NEGATIVE PATIENT OUTCOME. THE TR BAND DID NOT LOSE AIR. THEY SUCCESSFULLY ACHIEVED HEMOSTASIS. THE CUSTOMER STATED THAT THE PLASTIC ON THE NEW TR BAND IS MUCH MORE SLIPPERY AND DIFFICULT TO PLACE IT CORRECTLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1986963 TR BAND RADIAL COMPRESSION DEVICE CLAMP, VASCULAR DXC TERUMO MEDICAL CORPORATION N/A

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown RADIAL SHEATH