FDA Adverse Event Injury Summary report: N

AVANTA FLUID MANAGEMENT SYSTEM

MDR report key: 21218217 · Received January 23, 2025

Report

Report Number
2520313-2025-00001
Event Type
Injury
Date Received
January 23, 2025
Date of Event
October 1, 2024
Report Date
February 6, 2025
Manufacturer
BAYER MEDICAL CARE INC
Product Code
DXT
UDI-DI
00616258008578
PMA / PMN Number
K050456
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A SYSTEM SERVICE CHECK REPORT OF THE MEDRAD® AVANTA FLUID MANAGEMENT INJECTION SYSTEM (SERIAL NUMBER (B)(6) ) HAS BEEN SCHEDULED. THE MEDRAD® SINGLE-PATIENT DISPOSABLE SET (SPAT, LOT NUMBER UNKNOWN) AND THE MULTI-PATIENT DISPOSABLE SET (MPAT, LOT NUMBER UNKNOWN) IN USE DURING THE INCIDENT WERE NOT SAVED. LOT NUMBERS FOR THE SUBJECT DISPOSABLES WERE NOT PROVIDED; THEREFORE, TESTING OF RETAINED SAMPLES IS NOT POSSIBLE. THIS INVESTIGATION REMAINS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A FOLLOW-UP REPORT WILL BE SUBMITTED. THE AVANTA FLUID MANAGEMENT SYSTEM OPERATION MANUAL CAUTIONS THE USER AS FOLLOWS: "WARNING: EXPEL ALL AIR FROM THE SYRINGE, DRIP CHAMBERS, CONNECTORS, TUBING, TRANSDUCER, AND CATHETER BEFORE CONNECTING THE SYSTEM TO THE PATIENT." THIS INFORMATION DOES NOT CONSTITUTE AN ADMISSION THAT THE DEVICE, THE COMPANY, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO A REPORTABLE EVENT.

Additional Manufacturer Narrative · 0

A SYSTEM SERVICE CHECK OF THE MEDRAD® AVANTA FLUID MANAGEMENT INJECTION SYSTEM, SERIAL NUMBER (B)(6), WAS PERFORMED ON (B)(6) 2025, WHICH CONFIRMED THAT THE INJECTOR WAS OPERATING WITHIN BAYER SPECIFICATIONS. THE MEDRAD® SINGLE-PATIENT DISPOSABLE SET (SPAT, LOT NUMBER UNKNOWN) AND THE MULTI-PATIENT DISPOSABLE SET (MPAT, LOT NUMBER UNKNOWN) IN USE DURING THE INCIDENT WERE NOT SAVED. LOT NUMBERS FOR THE SUBJECT DISPOSABLES WERE NOT PROVIDED; THEREFORE, TESTING OF RETAINED SAMPLES IS NOT POSSIBLE. THE OFFER OF ADDITIONAL APPLICATIONS TRAINING WAS ACCEPTED BY THE CUSTOMER AND WILL BE SCHEDULED THIS MONTH. THE AVANTA FLUID MANAGEMENT SYSTEM OPERATION MANUAL CAUTIONS THE USER AS FOLLOWS: "WARNING: EXPEL ALL AIR FROM THE SYRINGE, DRIP CHAMBERS, CONNECTORS, TUBING, TRANSDUCER, AND CATHETER BEFORE CONNECTING THE SYSTEM TO THE PATIENT." THIS INFORMATION DOES NOT CONSTITUTE AN ADMISSION THAT THE DEVICE, THE COMPANY, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO A REPORTABLE EVENT.

Description of Event or Problem · 0

BAYER MEDICAL CARE INC. WAS INFORMED THAT A 60-YEAR-OLD MALE EXPERIENCED AN ALLEGED AIR INJECTION DURING A HEART CATHETERIZATION PROCEDURE WHILE CONNECTED TO A MEDRAD® AVANTA FLUID MANAGEMENT INJECTION SYSTEM (SN (B)(6)). THE CUSTOMER REPORTED THAT AN UNDISCLOSED AMOUNT OF AIR WAS VISUALIZED AFTER A CONTRAST INJECTION IN THE LEFT CORONARY SYSTEM. FOLLOWING THE EVENT, THE PATIENT WENT INTO CARDIAC ARREST, WAS IMMEDIATELY RESUSCITATED AND WAS SUCCESSFULLY STABILIZED. THE PATIENT IS REPORTED AS DOING WELL.

Description of Event or Problem · 0

BAYER MEDICAL CARE INC. WAS INFORMED THAT A 60-YEAR-OLD MALE EXPERIENCED AN ALLEGED AIR INJECTION DURING A HEART CATHETERIZATION PROCEDURE WHILE CONNECTED TO A MEDRAD® AVANTA FLUID MANAGEMENT INJECTION SYSTEM (SN (B)(6)). THE CUSTOMER REPORTED THAT AN UNDISCLOSED AMOUNT OF AIR WAS VISUALIZED AFTER A CONTRAST INJECTION IN THE LEFT CORONARY SYSTEM. FOLLOWING THE EVENT, THE PATIENT WENT INTO CARDIAC ARREST, WAS IMMEDIATELY RESUSCITATED AND WAS SUCCESSFULLY STABILIZED. THE PATIENT IS REPORTED AS DOING WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
489740 AVANTA FLUID MANAGEMENT SYSTEM ANGIOGRAPHIC INJECTOR DXT BAYER MEDICAL CARE INC 60726742 00616258008578

Patients

Seq Age Sex Outcome Treatment
1 60 YR Male Other MULTI-PATIENT DISPOSABLE SET (MPAT).| MULTI-PATIENT DISPOSABLE SET (MPAT).| SINGLE-PATIENT DISPOSABLE SET (SPAT).| SINGLE-PATIENT DISPOSABLE SET (SPAT).