FDA Adverse Event Injury Summary report: N

ARROW REDIGUARD IAB: 8FR 50CC

MDR report key: 18058031 · Received November 2, 2023

Report

Report Number
3010532612-2023-00628
Event Type
Injury
Date Received
November 2, 2023
Date of Event
October 18, 2023
Report Date
October 19, 2023
Manufacturer
ARROW INTERNATIONAL LLC
Product Code
DSP
PMA / PMN Number
K010330
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

(B)(4). THE REPORTED COMPLAINT FOR "BALLOON WOULD NOT UNWRAP" WAS NOT ABLE TO BE CONFIRMED AS THE PRODUCT WAS NOT RETURNED FOR INVESTIGATION. A DEVICE HISTORY RECORD (DHR) REVIEW WAS UNABLE TO BE COMPLETED AS NO SERIAL/LOT NUMBER WAS REPORTED. THE ROOT CAUSE OF THE COMPLAINT WAS UNDETERMINED. NO FURTHER ACTION REQUIRED AT THIS TIME. TELEFLEX WILL CONTINUE TO MONITOR AND TREND ON REPORTS OF THIS NATURE.

Additional Manufacturer Narrative · 0

(B)(4). OTHER REMARKS: N/A CORRECTED DATA: N/A.

Additional Manufacturer Narrative · 0

(B)(4). IN SECTION D ADDED THE INFORMATION AVAILABLE FOR THE UDI #, THERE WAS NO LOT NUMBER REPORTED. THEREFORE, THE FULL UDI # IS UNABLE TO BE PROVIDED. **UDI RELATED DATA QUALITY UPDATES ONLY** OTHER REMARKS: N/A. CORRECTED DATA: N/A.

Description of Event or Problem · 0

IT WAS REPORTED THAT "IAB PLACEMENT ATTEMPTED ON LF, NO ISSUES OR DIFFICULTY NOTED WITH INSERTION, CONSTANT HIGH PRESSURE ALARMS ON PUMP, PUMP EXCHANGED, HIGH PRESSURE ALARMS CONTINUED. VOLUME DECREASED TO 40CC. MANUAL INFLATION NOT ATTEMPTED DUE TO LACK OF VISUAL PLACEMENT (IN OR) CXR CONFIRMED PROPER PLACEMENT. 2ND IAB INSERTED ON RF WITH SAME RESULT. 2ND IAB WAS KEPT FOR RETURN PHOTOS SHOW IAB STILL TIGHTLY WRAPPED. [THE PERFUSIONIST] STATED HE ALSO ATTEMPTED TO INFLATE IAB WITH THE PUMP IN INTERNAL TRIGGER AFTER THE IAB WAS REMOVED. HIGH PRESSURE ALARMS STILL NOTED AND IAB DID NOT UNWRAP. PATIENT WAS MEDICALLY STABILIZED AND TRANSFERRED TO THE ICU WHERE HE REMAINED STABLE WITHOUT IAB PLACEMENT". SEE ASSOCIATED MDR #3010532612-2023-00629.

Description of Event or Problem · 0

IT WAS REPORTED THAT "IAB PLACEMENT ATTEMPTED ON LF, NO ISSUES OR DIFFICULTY NOTED WITH INSERTION, CONSTANT HIGH PRESSURE ALARMS ON PUMP, PUMP EXCHANGED, HIGH PRESSURE ALARMS CONTINUED. VOLUME DECREASED TO 40CC. MANUAL INFLATION NOT ATTEMPTED DUE TO LACK OF VISUAL PLACEMENT (IN OR) CXR CONFIRMED PROPER PLACEMENT. 2ND IAB INSERTED ON RF WITH SAME RESULT. 2ND IAB WAS KEPT FOR RETURN PHOTOS SHOW IAB STILL TIGHTLY WRAPPED. (THE PERFUSIONIST) STATED HE ALSO ATTEMPTED TO INFLATE IAB WITH THE PUMP IN INTERNAL TRIGGER AFTER THE IAB WAS REMOVED. HIGH PRESSURE ALARMS STILL NOTED AND IAB DID NOT UNWRAP. PATIENT WAS MEDICALLY STABILIZED AND TRANSFERRED TO THE ICU WHERE HE REMAINED STABLE WITHOUT IAB PLACEMENT". SEE ASSOCIATED MDR #3010532612-2023-00629.

Description of Event or Problem · 0

IT WAS REPORTED THAT "IAB PLACEMENT ATTEMPTED ON LF, NO ISSUES OR DIFFICULTY NOTED WITH INSERTION, CONSTANT HIGH PRESSURE ALARMS ON PUMP, PUMP EXCHANGED, HIGH PRESSURE ALARMS CONTINUED. VOLUME DECREASED TO 40CC. MANUAL INFLATION NOT ATTEMPTED DUE TO LACK OF VISUAL PLACEMENT (IN OR) CXR CONFIRMED PROPER PLACEMENT. 2ND IAB INSERTED ON RF WITH SAME RESULT. 2ND IAB WAS KEPT FOR RETURN PHOTOS SHOW IAB STILL TIGHTLY WRAPPED. [THE PERFUSIONIST] STATED HE ALSO ATTEMPTED TO INFLATE IAB WITH THE PUMP IN INTERNAL TRIGGER AFTER THE IAB WAS REMOVED. HIGH PRESSURE ALARMS STILL NOTED AND IAB DID NOT UNWRAP. PATIENT WAS MEDICALLY STABILIZED AND TRANSFERRED TO THE ICU WHERE HE REMAINED STABLE WITHOUT IAB PLACEMENT". SEE ASSOCIATED MDR #3010532612-2023-00629.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
131592 ARROW REDIGUARD IAB: 8FR 50CC SYSTEM, BALLOON, INTRA-AORTIC DSP ARROW INTERNATIONAL LLC UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 80 YR Male