FDA Adverse Event Other Summary report: N

CT GAMMA DIALYZER (CT 110G)

MDR report key: 301936 · Received October 24, 2000

Report

Report Number
1423500-2000-01071
Event Type
Other
Date Received
October 24, 2000
Date of Event
May 17, 2000
Report Date
September 25, 2000
Manufacturer
NISSHO CORP.
Product Code
FJI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

BAXTER AFFILIATE REPORTS ONE INCIDENT OF HEMOLYSIS. 4 HOURS AFTER THE INITIATION OF THE HEMODIALYSIS SESSION, THE PT EXPERIENCED HYPERTENSIVE CRISIS (BLOOD PRESSURE 200/90) ASSOCIATED WITH NAUSEA AND VOMITING, TINNITUS. THE PT WAS HOSPITALIZED FROM 2000 TO 2000 AND HEMOLYSIS WAS DIAGNOSED. PT HAS SINCE RECOVERED. THE MACHINE IN USE AT THE TIME OF THE INCIDENT IS STILL IN USE ACCORDING TO CENTER PERSONNEL WITHOUT PROBLEMS NOTED. ALL DISPOSABLES WERE DISPOSED OF BY CENTER PERSONNEL AT THE END OF THE TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CT GAMMA DIALYZER (CT 110G) HOLLOW FIBER DIALYZER FJI NISSHO CORP. CT 110G NA01

Patients

Seq Age Sex Outcome Treatment
1 54 YR Hospitalization| O