FDA Adverse Event Injury Summary report: N

ALP 501

MDR report key: 2739073 · Received September 1, 2012

Report

Report Number
2023637-2012-00002
Event Type
Injury
Date Received
September 1, 2012
Date of Event
June 18, 2012
Report Date
June 29, 2012
Manufacturer
CURRIE MEDICAL SPECIALTIES
Product Code
JOW
PMA / PMN Number
K955853
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE USER REPORTED THAT THE INJURY OBTAINED BY THE PT, WAS DUE TO THE PT TRIPPING OVER "VENODYNE BOOTS". WE HAVE BEEN UNABLE TO CONFIRM THAT THE PT WAS IN FACT WEARING "VENODYNE" BRAND BOOTS AS OPPOSED TO ALP GARMENT(S) THROUGH CORRESPONDENCE WITH THE REPORTING PARTY. WE HAVE INFORMED THE REPORTING PARTY, THAT OUR ALP 501 PUMP IS NOT TO BE USED WITH ANOTHER MFR'S DEVICE. VENODYNE BRAND COMPRESSION GARMENTS ARE NOT MANUFACTURED BY CURRIE MEDICAL SPECIALTIES INC., AND ARE NOT CLEARED FOR USE WITH OUR ALP 501 PUMP. THE INTENDED USE OF THE ALP 501 PUMP IS WITH THE ALP SERIES GARMENTS CLEARED UNDER 510(K) K955853 ONLY. DURING OUR EVAL OF THE CLAIM, IT WAS FOUND THAT THIS DEATH OCCURRED OUTSIDE OF THE BED. THE USER HAS BEEN NOTIFIED THAT THE OPERATIONS MANUAL FOR THE ALP 501 PUMP SPECIFICALLY STATES "IF THE PT IS AMBULATORY, TURN THE PUMP OFF AN DISCONNECT THE TUBING FROM THE GARMENTS. THE PT MAY AMBULATE WITH ONLY THE CALF AND THIGH GARMENTS IN PLACE. ONCE THE PT RETURNS TO THE CHAIR OR BED, CONNECT THE TUBING TO THE GARMENTS AND TURN THE PUMP ON." IF THE PT WAS AMBULATORY AS DESCRIBED ON FORM 3500A, THE HEALTH PROFESSIONAL SHOULD HAVE DISCONNECTED THE PT PRIOR TO ALLOWING THE PT TO LEAVE THE BED. THIS WOULD HAVE PREVENTED THE INJURY IF THE DIRECTIONS WITHIN THE OPERATOR'S MANUAL WERE FOLLOWED CORRECTLY. CURRIE MEDICAL SPECIALTIES HAS REQUESTED MORE INFO THE REPORTING PARTY ON THE FOLLOWING DATES WITH NO SUCCESS: (B)(4) 2012-EMAIL, (B)(4) 2012-EMAIL, (B)(4) 2012-PHONE, (B)(4) 2012-PHONE, (B)(4) 2012-EMAIL.

Description of Event or Problem · 1

AT 7:45PM, PT WAS FOUND ON FLOOR. HE STATED HE TRIPPED OVER HIS VENODYNE BOOTS WHILE WALKING INTO THE BATHROOM. HE WAS LAYING ON HIS RIGHT SIDE, WITH RIGHT ARM UNDER HIS HEAD. PT COMPLAINED OF PAIN IN LEFT SHOULDER AND ARM. XRAY SHOWED COMMINUTED PROXIMAL LEFT HUMERAL FRACTURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ALP 501 ALTERNATING LEG PRESSURE PUMP JOW CURRIE MEDICAL SPECIALTIES ALP 501

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention