FDA Adverse Event Injury Summary report: N

CRESCENT BICAVAL CATHETER 32 FR

MDR report key: 19981326 · Received August 14, 2024

Report

Report Number
3011468686-2024-00018
Event Type
Injury
Date Received
August 14, 2024
Date of Event
July 16, 2024
Report Date
August 14, 2024
Manufacturer
MC3 INC.
Product Code
PZS
UDI-DI
10854916006826
PMA / PMN Number
K180151
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Description of Event or Problem · 0

MEDTRONIC RECEIVED INFORMATION THAT DURING USE OF AN MC3 CRESCENT JUGULAR DUAL LUMEN CATHETER, IT WAS REPORTED THAT WHEN THE CUSTOMER CONNECTED THE EXTRA CORPOREAL MEMBRANE OXYGENATION (ECMO) CIRCUIT TUBING, THERE WAS WHAT LOOKED TO BE A TEAR IN THE CANNULA, NEAR THE CONNECTOR. THE CUSTOMER CHANGED TO A NEW CRESCENT, BUT DURING THE EXCHANGE THE TEAR WORSENED AND EVENTUALLY BROKE OFF OUTSIDE THE PATIENT. THE PATIENT EXPERIENCED HEMORRHAGIC SHOCK DUE TO HAVING TO EXCHANGE THE CANNULA. MEDTRONIC RECEIVED ADDITIONAL INFORMATION THAT THE PROCEDURE HAD BEEN A RELATIVELY SMOOTH CANNULATION UP UNTIL THAT POINT. THE CUSTOMER'S CLAMPS WERE NEVER ON THE AFFECTED PORTION OF THE CANNULA, AND WHILE IT SEEMS THAT IT WOULD HAVE MOST LIKELY TORN DURING CONNECTION OF THE TUBING TO THE CANNULA, THE CONNECTION WAS VERY SMOOTH, AND THE PHYSICIAN DID NOT STRUGGLE TO GET IT ON OR HAVE TO DISCONNECT AND RECONNECT. THEY ONLY DISCOVERED THE TEAR AFTER UNCLAMPING THE CIRCUIT AND SUDDENLY HAVING BLOOD LEAKING. WHILE CHANGING OUT THE CANNULA, IT CONTINUED TO TEAR, SO RECANNULATING THE NEW CRESCENT WAS DELAYED. ULTIMATELY THE PATIENT WENT INTO HEMORRHAGIC SHOCK AND NEEDED BLOOD BUT SURVIVED ECMO AND WAS DECANNULATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
220727 CRESCENT BICAVAL CATHETER 32 FR DUAL LUMEN ECMO CANNULA PZS MC3 INC. 70132 2205273 10854916006826

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Life Threatening| R