FDA Adverse Event Malfunction Summary report: N

PSI KIT: 8.5 FR

MDR report key: 2505782 · Received March 22, 2012

Report

Report Number
3006425876-2012-00023
Event Type
Malfunction
Date Received
March 22, 2012
Date of Event
February 2, 2012
Report Date
March 20, 2012
Manufacturer
ARROW INTERNATIONAL INC.
Product Code
KGZ
PMA / PMN Number
K780532
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). FOLLOW-UP REPORT WILL BE FILED IF ADD'L INFO BECOMES AVAILABLE.

Description of Event or Problem · 1

IT HAS BEEN REPORTED THAT THE PROCEDURE WAS BEING PERFORMED ON A MALE PT IN THE (B)(4). THE CATHETER WAS PLACED INTO THE PT'S INTERNAL JUGULAR. DURING POST OP CARE THE CLINICIAN NOTICED LEAKAGE AROUND THE 7FR SWAN GANZ CATHETER OVERNIGHT. IT WAS NOTED THAT BOTH THE INTRODUCER AND CATHETER WERE THEN REMOVED AND DISCONTINUED USE. NO ADVERSE ACTION WAS CAUSED. THERE WAS NO DELAY IN TREATMENT, NO PT DEATH, AND NO PT COMPLICATIONS WERE REPORTED. THE PT OUTCOME WAS OKAY. ON (B)(6) 2012 - FOLLOW UP INFO CONFIRMS THEY ALWAYS USES A 7FR CATHETER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PSI KIT: 8.5 FR CRITICAL CARE PSI PRODUCTS KGZ ARROW INTERNATIONAL INC. NA

Patients

Seq Age Sex Outcome Treatment
1 UNK