FDA Adverse Event Malfunction Summary report: N

CVVH, BLOOD PUMP

MDR report key: 2454051 · Received January 30, 2012

Report

Report Number
2454051
Event Type
Malfunction
Date Received
January 30, 2012
Date of Event
December 27, 2011
Report Date
January 24, 2012
Manufacturer
GAMBRO RENAL PRODUCTS, INC.
Product Code
KDI
Product Problem
Yes
Report Source
User Facility report
Reporter Location
MI, US

Narratives

Description of Event or Problem · 1

THE PATIENT WAS ON CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT). CRRT MACHINE WAS ALARMING: MALFUNCTION, MEMORY ERROR. AN ERROR CODE 6 ALSO OCCURRED DUE TO A SET VALUE INCONGRUENCE BETWEEN THE PROTECTIVE AND CONTROL ON THE CRRT. BLOOD WAS GIVEN BACK TO THE PATIENT. THE PATIENT WAS RESTARTED ON A NEW CRRT MACHINE. DIALYSIS UNIT WAS CALLED. WE ARE AWAITING A RESPONSE FROM THE MFR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CVVH, BLOOD PUMP DIALYSIS EQUIPMENT (DESCRIBE BELOW) KDI GAMBRO RENAL PRODUCTS, INC. PRISMAFLEX *

Patients

Seq Age Sex Outcome Treatment
1 65 YR