FDA Adverse Event Death Summary report: N

NURSE ASSIST, LLC

MDR report key: 19826519 · Received July 25, 2024

Report

Report Number
3002695476-2024-00042
Event Type
Death
Date Received
July 25, 2024
Report Date
June 24, 2024
Manufacturer
NURSE ASSIST, LLC
Product Code
FRO
PMA / PMN Number
K083042
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
003

Narratives

Additional Manufacturer Narrative · 0

A FOLLOW-UP CALL WAS SENT TO (B)(6) BY THE COMPLAINTS DEPARTMENT ON 6/24/2024 REQUESTING ADDITIONAL INFORMATION TO AID WITH REPORTING AND WITH THE INVESTIGATION.

Additional Manufacturer Narrative · 0

UPDATED INFORMATION PER PHONE CALL ON (B)(6) 2024: PATIENT WAS UNSURE IF NURSE ASSIST PRODUCT WAS USED.

Additional Manufacturer Narrative · 0

FOLLOW-UP 01: UPDATED INFORMATION PER PHONE CALL ON (B)(6) 2024: PATIENT WAS UNSURE IF NURSE ASSIST PRODUCT WAS USED. FOLLOW-UP 02: A CORRECTION WAS MADE IN SECTION H11 WHERE 5-DAY BOX WAS INCORRECTLY CHECKED WHEN IT SHOULD HAVE BEEN 30-DAY.

Description of Event or Problem · 0

ON 06/21/2024, CUSTOMER SERVICE RECEIVED A CALL FROM (B)(6). CUSTOMER SERVICE DEPARTMENT SENT AN EMAIL DESCRIBING THE CALL THEY HAD WITH (B)(6) TO THE COMPLAINTS DEPARTMENT ON 06/21/2024. DESCRIPTION OF EMAIL SENT TO COMPLAINTS DEPARTMENT: SHE WAS CHANGING THE DRESSINGS ON HER HUSBAND WOUNDS, AND HE SUDDENLY HAD A RAPID DECLINE. THERE WAS SOME YELLOW DRAINAGE FROM THE TUBE THAT THE NURSE NOTICED. SHE JUST WANTS PIECE OF MIND THAT IT WAS NO ONE'S FAULT JUST LIFE. HER NAME IS (B)(6) AND HER HUSBAND'S NAME WAS (B)(6).

Description of Event or Problem · 0

UPDATED INFORMATION: NURSE ASSIST CONTACTED PATIENT ON (B)(6) 2024 TO OBTAIN ADDITIONAL INFORMATION. PATIENT DID NOT HAVE PART NUMBER OR LOT NUMBER AND WAS UNSURE IF THE PRODUCT USED WAS FROM NURSE ASSIST. ORIGINAL INFORMATION: ON 06/21/2024, CUSTOMER SERVICE RECEIVED A CALL FROM (B)(6). CUSTOMER SERVICE DEPARTMENT SENT AN EMAIL DESCRIBING THE CALL THEY HAD WITH (B)(6) TO THE COMPLAINTS DEPARTMENT ON 06/21/2024. DESCRIPTION OF EMAIL SENT TO COMPLAINTS DEPARTMENT: SHE WAS CHANGING THE DRESSINGS ON HER HUSBAND WOUNDS, AND HE SUDDENLY HAD A RAPID DECLINE. THERE WAS SOME YELLOW DRAINAGE FROM THE TUBE THAT THE NURSE NOTICED. SHE JUST WANTS PIECE OF MIND THAT IT WAS NO ONE'S FAULT JUST LIFE. HER NAME IS (B)(6) AND HER HUSBAND'S NAME WAS (B)(6).

Description of Event or Problem · 0

UPDATED INFORMATION: NURSE ASSIST CONTACTED PATIENT ON (B)(6) 2024 TO OBTAIN ADDITIONAL INFORMATION. PATIENT DID NOT HAVE PART NUMBER OR LOT NUMBER AND WAS UNSURE IF THE PRODUCT USED WAS FROM NURSE ASSIST. ORIGINAL INFORMATION: ON 06/21/2024, CUSTOMER SERVICE RECEIVED A CALL FROM (B)(6). CUSTOMER SERVICE DEPARTMENT SENT AN EMAIL DESCRIBING THE CALL THEY HAD WITH (B)(6) TO THE COMPLAINTS DEPARTMENT ON 06/21/2024. DESCRIPTION OF EMAIL SENT TO COMPLAINTS DEPARTMENT: SHE WAS CHANGING THE DRESSINGS ON HER HUSBAND WOUNDS, AND HE SUDDENLY HAD A RAPID DECLINE. THERE WAS SOME YELLOW DRAINAGE FROM THE TUBE THAT THE NURSE NOTICED. SHE JUST WANTS PIECE OF MIND THAT IT WAS NO ONE'S FAULT JUST LIFE. HER NAME IS (B)(6) AND HER HUSBAND'S NAME WAS (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
365348 NURSE ASSIST, LLC DRESSING, WOUND, DRUG FRO NURSE ASSIST, LLC

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Death