BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MONARCH PLATFORM

    MDR report key: 18276972 · Received December 6, 2023

    Report

    Report Number
    3014447948-2023-00029
    Event Type
    Injury
    Date Received
    December 6, 2023
    Date of Event
    November 3, 2023
    Report Date
    January 3, 2024
    Manufacturer
    AURIS HEALTH, INC.
    Product Code
    EOQ
    UDI-DI
    B634MON0000060
    PMA / PMN Number
    K211493
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    PHYSICIAN
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    SYSTEM LOGS WERE NOT AVAILABLE FOR REVIEW BECAUSE THE SYSTEM LOGS WERE NOT COMPLETE AND FAILURE ANALYSIS WAS UNABLE TO CONFIRM THE OCCURRENCE OF ANY FAULTS OR ERRORS THAT COULD HAVE CONTRIBUTED TO THE REPORTED ISSUE. HOWEVER, THERE WERE NO DEVICE MALFUNCTIONS REPORTED FROM THE PROCEDURE AND THE CUSTOMER DID NOT ATTRIBUTE THE ADVERSE EVENT TO THE MONARCH SYSTEM. A DEVICE HISTORY RECORD (DHR) REVIEW WAS PERFORMED FOR THE SYSTEM AND THERE WERE NO NON-CONFORMANCES RELATED TO THE PNEUMOTHORAX REPORTED IN THIS CASE. BASED ON THE INFORMATION AVAILABLE FOR THIS COMPLAINT, THE ROOT CAUSE OF THE REPORTED EVENT IS RELATED TO A KNOWN INHERENT RISK OF THE DEVICE AND PROCEDURE AS DOCUMENTED IN THE LABELING.

    Additional Manufacturer Narrative · 0

    THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH HAS NOT BEEN INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY AURIS HEALTH, INC., OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE PRODUCT, AURIS HEALTH, INC., OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE.

    Description of Event or Problem · 0

    IT WAS REPORTED THAT PHYSICIAN OBSERVED EXCESS AMOUNT OF BLOOD IN THE AIR WAY AFTER SUCCESSFULLY COMPLETING THE MONARCH BRONCHOSCOPY PROCEDURE. THE PHYSICIAN ELECTED TO USE THEIR MANUAL BRONCHOSCOPE AND COLD SALINE TO CLEAR THE AIRWAY; HOWEVER, COMPLICATIONS OCCURRED DURING THE POST-MONARCH BRONCHOSCOPY PROCEDURE. THE PATIENTS BLOOD HAD CLOTTED AND BLOCKED THE ENDOTRACHEAL TUBE (ET TUBE). THE PATIENT THEN FELL INTO CARDIAC ARREST DUE TO LACK OF VENTILATION FROM THE FROM THE BLOOD CLOT BEING PRESENT IN THE ENDOTRACHEAL TUBE (ET TUBE). THE PHYSICIAN FOLLOWED CARDIAC ARREST PROTOCOL AND WAS ABLE TO RECOVER THE PATIENT. THE PATIENT WAS ADMITTED INTO INTENSIVE CARE UNIT (ICU) ON THE SAME DAY. AFTER THE PATIENT WAS SENT TO RECOVERY IN THE INTENSIVE CARE UNIT (ICU), THE PATIENT WAS GIVEN A CHEST X-RAY WHERE DOCTOR DISCOVERED THE PATIENT HAD EXPERIENCED A PNEUMOTHORAX. A CHEST TUBE WAS PLACED AND REMOVED THE FOLLOWING DAY. THE PHYSICIAN STATED THE PNEUMOTHORAX WAS DUE TO LONG BAG VENTILATION TIME, EXCESS SUCTION, AND OVER ALL STRESS ON THE LUNG THAT OCCURRED DURING BLEEDING MANAGEMENT POST-MONARCH PROCEDURE. THE PATIENT HAS BEEN RELEASED FROM THE HOSPITAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    730461 MONARCH PLATFORM BRONCHOSCOPE (FLEXIBLE OR RIGID) AND ACCESSORIES EOQ AURIS HEALTH, INC. MON-000006 B634MON0000060

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown Hospitalization| R