FDA Adverse Event Other Summary report: N

PRISMAFLEX

MDR report key: 2136550 · Received September 21, 2007

Report

Report Number
9616026-2007-00098
Event Type
Other
Date Received
September 21, 2007
Date of Event
August 21, 2007
Report Date
August 22, 2007
Manufacturer
GAMBRO LUNDIA AB
Product Code
KDI
PMA / PMN Number
K041005
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED INCIDENT HAS BEEN CLASSIFIED AS A FLOW RATE DISCREPANCY. THE TREATMENT FILES ARE NOT AVAILABLE. THE ACTUAL FLOW RATE DISCREPANCY WAS 20 ML/MIN, THE PT WAS ASYMPTOMATIC AND NO MEDICAL INTERVENTION REQUIRED. GAMBRO LUNDIA AB HAS DEVELOPED A PROCEDURE FOR FLOW RATE DISCREPANCY, AS DESCRIBED IN THE ADVISORY NOTICE 019 DATED (B)(4) 2007, SOFTWARE CHANGES HAVE ALSO BEEN MADE, WHEN WILL BE IMPLEMENTED IN FUTURE REVISION.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT SET BLOOD FLOW RATE IS NOT THE SAME AS ON THE STATUS SCREEN. NO PT INJURY OR CLINICAL CONSEQUENCES WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRISMAFLEX INTENSIVE CARE HEMODIALYSIS KDI GAMBRO LUNDIA AB 107493

Patients

Seq Age Sex Outcome Treatment
1 UNK Other