FDA Adverse Event Other Summary report: N

EXACTA-MIX 2400 COMPOUNDER

MDR report key: 1837380 · Received September 7, 2010

Report

Report Number
1419106-2010-00017
Event Type
Other
Date Received
September 7, 2010
Date of Event
August 12, 2010
Report Date
August 13, 2010
Manufacturer
BAXA CORPORATION
Product Code
LHI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AR, US
Reporter Occupation
PHARMACIST

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL CONTACT WITH USER FACILITY WAS UNSUCCESSFUL. RESULTS: ERRONEOUS DATA.

Description of Event or Problem · 1

ON (B)(6) 2010, (B)(6) CENTER'S PHARMACIST CALLED BAXA TECHNICAL SUPPORT TO REPORT THAT A PT, WHO HAD RECEIVED TOTAL PARENTERAL NUTRITION (TPN) ON (B)(6) 2010, EXPERIENCED AN ADVERSE REACTION THAT REQUIRED RESUSCITATION DUE TO AN UNEXPECTED DELIVERY OF POTASSIUM. FURTHER INFO FROM THE USER FACILITY REVEALED THAT POTASSIUM (K) PHOSPHATE INSTEAD OF SODIUM (NA) PHOSPHATE WAS DELIVERED TO THE PT. AS A RESULT, MEDICAL INTERVENTION WAS REQUIRED TO REVIVE AND STABILIZE THE PT. THE USER FACILITY STATED THAT "SEVERAL MEDICATIONS WERE ADMINISTERED TO LOWER THE POTASSIUM LEVEL" OF THE PT. AT THE TIME OF THE INITIAL REPORT, THE PT HAD RECOVERED WITH NO FURTHER SYMPTOMS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 EXACTA-MIX 2400 COMPOUNDER EXACTA-MIX 2400 LHI BAXA CORPORATION 2400-M

Patients

Seq Age Sex Outcome Treatment
1 2 DA Required Intervention