BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ON-Q PAIN PUMP

    MDR report key: 2912988 · Received January 9, 2013

    Report

    Report Number
    2026095-2012-00329
    Event Type
    Injury
    Date Received
    January 9, 2013
    Date of Event
    August 1, 2006
    Report Date
    December 11, 2012
    Manufacturer
    I-FLOW, LLC
    Product Code
    MEB
    PMA / PMN Number
    K063530
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    METHOD: NO PRODUCT WAS RETURNED FOR EVALUATION AND INVESTIGATION. LOT INFORMATION IS PENDING. A FOLLOW-UP REPORT WILL BE FILED ONCE THE INFORMATION BECOMES AVAILABLE. RESULTS: THE INFORMATION CONTAINED IS FROM LEGAL DOCUMENTS SERVED ON I-FLOW, LLC. THE COMPLAINT WAS OPENED, SO THAT A MEDICAL DEVICE REPORT (MDR) CAN BE FILED WITH THE US FOOD AND DRUG ADMINISTRATION. NO FURTHER INVESTIGATION WILL BE CONDUCTED. CONCLUSIONS: AS THIS COMPLAINT WAS CREATED FROM A LAWSUIT SERVED ON I-FLOW OR TH THREAT OF A LAWSUIT, NO CUSTOMER CONTACT CAN BE MADE AT THIS TIME DUE TO THE PENDING OR THREATENED LITIGATION." AS OF 11/09/2006 I-FLOW UPDATED THE ON-Q PUMP DIRECTIONS FOR USE (DFU), TO INCLUDE THE FOLLOWING IN THE WARNINGS SECTION: "AVOID PLACING THE CATHETER IN JOINT SPACES. ALTHOUGH THERE IS NO DEFINITIVE ESTABLISHED CAUSAL RELATIONSHIP, SOME LITERATURE HAS SHOWN A POSSIBLE ASSOCIATION BETWEEN CONTINUOUS INTRA-ARTICULAR INFUSIONS (PARTICULARLY WITH BUPIVACAINE) AND THE SUBSEQUENT DEVELOPMENT OF CHONDROLYSIS." (DFU 1307011). ON 08/08/2007, I-FLOW HAS ALSO PREPARED A TECHNICAL BULLETIN ENTITLED "WHAT WE KNOW ABOUT CHONDROLYSIS TODAY"., (1303722, REV.E).

    Description of Event or Problem · 1

    DRUG/DILUENT: MARCAINE 0.25%. FILL VOLUME: 10ML. FLOW RATE: 2ML/HR. PROCEDURE: RIGHT SHOULDER ARTHROSCOPY, DEBRIDEMENT OF SMALL FRAYING. ROTATOR CUFF REPAIR. SUBACROMIAL DECOMPRESSION. DISTAL CLAVICLE EXCISION. CATHPLACE: UNKNOWN. PATIENT ALLEGES CARTILAGE DAMAGE IN RIGHT SHOULDER FOLLOWING PLACEMENT OF AN ON-Q PAINBUSTER, PM012, AFTER SURGEON ON (B)(6) 2006.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    11425 ON-Q PAIN PUMP ELASTOMERIC PUMP MEB I-FLOW, LLC PM012 642472

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Other