FDA Adverse Event Malfunction Summary report: N

AN UNSPECIFIED CLOSED SYSTEM ART LINE TRANSUDUCER

MDR report key: 21636278 · Received March 18, 2025

Report

Report Number
9617594-2025-00501
Event Type
Malfunction
Date Received
March 18, 2025
Date of Event
January 2, 2025
Report Date
May 5, 2025
Manufacturer
ICU MEDICAL DE MEXICO, S. DE R.L. DE C.V.
Product Code
DRS
PMA / PMN Number
K061573
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE REPORTED COMPLAINT COULD NOT BE CONFIRMED. NO PRODUCT SAMPLES, PICTURES, OR VIDEOS WERE RECEIVED FOR INVESTIGATION. THEREFORE, A COMPREHENSIVE FAILURE INVESTIGATION CANNOT BE PERFORMED AND A CAUSE CANNOT BE DETERMINED. A MANUFACTURING RECORD REVIEW COULD NOT BE COMPLETED AS THE LOT NUMBER WAS NOT PROVIDED BY THE CUSTOMER.

Additional Manufacturer Narrative · 0

A2 - DATE OF BIRTH - THE PATIENTS AGE WAS USED TO APPROXIMATE THE DATE OF BIRTH AS (B)(6) 2019. . THE DEVICE WAS NOT SPECIFIED, AND THE 510K WAS ASSUMED TO BE K061573. THE INVESTIGATION IS PENDING COMPLETION. UPON COMPLETION OF THE INVESTIGATION A SUPPLEMENTAL MDR WILL BE SUBMITTED.

Description of Event or Problem · 0

A COMPLAINT WAS RECEIVED REGARDING AN UNSPECIFIED CLOSED SYSTEM ART LINE TRANSDUCER THAT EXPERIENCED DEVICE INACCURACY. THE REPORTER STATED THAT PATIENT'S ART LINE WAS NOT READING ACCURATELY. THE PATIENT INVOLVED WAS 6.14 YEARS OLD AND MALE. THE AFFECTED AREA OR UNIT LOCATION WAS H2B. THERE WERE NO OTHER DEVICES BEING USED ON THE PATIENT AT THE TIME OF THE EVENT THAT MAY HAVE CAUSED OR CONTRIBUTED TO THE EVENT. THUS, THERE WAS PATIENT INVOLVEMENT, NO HUMAN HARM AND UNKNOWN DELAY IN THERAPY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1592419 AN UNSPECIFIED CLOSED SYSTEM ART LINE TRANSUDUCER TRANSDUCER, BLOOD-PRESSURE, EXTRAVASCULAR DRS ICU MEDICAL DE MEXICO, S. DE R.L. DE C.V. UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 6 YR Male