FDA Adverse Event Other Summary report: N

MEDRAD ANGIOGRAPHIC INJECTOR

MDR report key: 272597 · Received April 5, 2000

Report

Report Number
2520313-2000-00002
Event Type
Other
Date Received
April 5, 2000
Date of Event
February 25, 2000
Report Date
April 4, 2000
Manufacturer
MEDRAD, INC.
Product Code
DXT
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

HOSPITAL REPORTED THEY HAD TWO INCIDENTS OF ANAPHYLATIC SHOCK. THE FIRST INCIDENT OCCURRED ON 2/25/00, THE SECOND ON 2/29/00. THE HOSP WAS DOING A REGULAR DIAGNOSTIC ANGIOGRAM, USING A MEDRAD MARK IV INJECTOR, 130 ML SYRINGE AND NON-IONIC ISOVUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MEDRAD ANGIOGRAPHIC INJECTOR ANGIOGRAPHIC INJECTOR DXT MEDRAD, INC. MKIV NA

Patients

Seq Age Sex Outcome Treatment
1 NA Required Intervention