FDA Adverse Event Injury Summary report: N

STELLANT DUAL CT INJECTOR

MDR report key: 21618830 · Received March 17, 2025

Report

Report Number
2520313-2025-00010
Event Type
Injury
Date Received
March 17, 2025
Date of Event
March 1, 2025
Report Date
May 1, 2025
Manufacturer
BAYER MEDICAL CARE INC
Product Code
DXT
UDI-DI
00616258025155
PMA / PMN Number
K082905
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IT
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

A SYSTEM SERVICE CHECK OF THE MEDRAD® STELLANT CT INJECTION SYSTEM (SN (B)(6)) WAS DECLINED BY THE CUSTOMER. THE STELLANT MULTI-PATIENT KIT (SDS MP2), BATCH NUMBER 8653312, THAT WAS IN USE DURING THE PROCEDURE WAS DISCARDED BY THE SITE; THEREFORE, IT IS NOT AVAILABLE FOR EVALUATION. RETAINED SAMPLES HAVE BEEN REQUESTED AND WILL BE EVALUATED ONCE RECEIVED. THIS INVESTIGATION REMAINS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A FOLLOW-UP REPORT WILL BE SUBMITTED. THIS INFORMATION DOES NOT CONSTITUTE AN ADMISSION THAT THE DEVICE, THE COMPANY, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO A REPORTABLE EVENT. CORRECTION NOTE: THE INITIAL MDR (2520313-2025-00010) DATED 03/17/2025 WAS SUBMITTED WITH AN INCORRECT SERIAL NUMBER. THE ORIGINAL INFORMATION PROVIDED BY THE CUSTOMER WAS LATER DETERMINED TO BE INCORRECT. THE CORRECT SERIAL NUMBER OF THE INJECTOR SYSTEM IS (B)(6).

Additional Manufacturer Narrative · 0

A SYSTEM SERVICE CHECK OF THE MEDRAD® STELLANT CT INJECTION SYSTEM (SN (B)(6)) WAS DECLINED BY THE CUSTOMER. THE STELLANT MULTI-PATIENT KIT (SDS MP2), BATCH NUMBER 8653312, THAT WAS IN USE DURING THE PROCEDURE WAS DISCARDED BY THE SITE; THEREFORE, IT IS NOT AVAILABLE FOR EVALUATION. BAYER PRODUCT ANALYSIS TESTED RETAINED SAMPLES OF THE SDS MP2, BATCH NUMBER 8653312, AND CONCLUDED THAT THE RETAINED DISPOSABLES PERFORMED TO SPECIFICATION WITH NO PROBLEMS OBSERVED. THE OFFER OF ADDITIONAL APPLICATIONS TRAINING WAS DECLINED BY THE CUSTOMER. THE MEDRAD® STELLANT INJECTION SYSTEM OPERATION MANUAL CAUTIONS THE USER AS FOLLOWS: WARNING: AIR EMBOLISM HAZARD: SERIOUS PATIENT INJURY OR DEATH MAY RESULT. ENSURE PATIENT IS NOT CONNECTED WHILE PURGING AIR FROM SYRINGE OR ENGAGING OR ADVANCING PLUNGER. EXPEL ALL TRAPPED AIR FROM THE SYRINGE(S), CONNECTORS, TUBING, AND CATHETER BEFORE CONNECTING THE SYSTEM TO THE PATIENT. TO MINIMIZE AIR EMBOLIZATION RISKS, ENSURE THAT ONE OPERATOR IS DESIGNATED THE RESPONSIBILITY OF FILLING THE SYRINGE(S). DO NOT CHANGE OPERATORS DURING THE PROCEDURE. IF AN OPERATOR CHANGE MUST OCCUR, ENSURE THAT THE NEW OPERATOR VERIFIES THAT THE FLUID PATH IS PURGED OF AIR. 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® STELLANT CT INJECTION SYSTEM (SN (B)(6) WAS DECLINED BY THE CUSTOMER. THIS INVESTIGATION REMAINS IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETED, A FOLLOW-UP REPORT WILL BE SUBMITTED. 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 40-YEAR-OLD MALE HAD EXPERIENCED AN ALLEGED AIR INJECTION WHILE CONNECTED TO A MEDRAD® STELLANT CT INJECTION SYSTEM (SN (B)(6)). THE AMOUNT OF AIR INJECTED IS UNKNOWN. FOLLOWING THE EVENT, THE PATIENT WAS TRANSFERRED TO A HYPERBARIC CHAMBER FOR FURTHER CARE AND TREATMENT AND IS REPORTED AS DOING WELL.

Description of Event or Problem · 0

BAYER MEDICAL CARE INC. WAS INFORMED THAT A 40-YEAR-OLD MALE HAD EXPERIENCED AN ALLEGED AIR INJECTION WHILE CONNECTED TO A MEDRAD® STELLANT CT INJECTION SYSTEM (SN (B)(6)). THE AMOUNT OF AIR INJECTED IS UNKNOWN. FOLLOWING THE EVENT, THE PATIENT WAS TRANSFERRED TO A HYPERBARIC CHAMBER FOR FURTHER CARE AND TREATMENT AND IS REPORTED AS DOING WELL.

Description of Event or Problem · 0

BAYER MEDICAL CARE INC. WAS INFORMED THAT A PATIENT HAD EXPERIENCED AN ALLEGED AIR INJECTION WHILE CONNECTED TO A MEDRAD® STELLANT CT INJECTION SYSTEM (SN (B)(6). THE AMOUNT OF AIR INJECTED IS UNKNOWN. FOLLOWING THE EVENT, THE PATIENT WAS TRANSFERRED TO A HYPERBARIC CHAMBER FOR FURTHER CARE AND TREATMENT AND IS REPORTED AS DOING WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
14402 STELLANT DUAL CT INJECTOR CT INJECTION SYSTEM DXT BAYER MEDICAL CARE INC 87924890 00616258025155

Patients

Seq Age Sex Outcome Treatment
1 40 YR Male Other STELLANT MULTI-PATIENT KIT (SDS MP2) BATCH 8653312| STELLANT MULTI-PATIENT KIT (SDS MP2) BATCH 8653312