FDA Adverse Event Malfunction Summary report: N

TRIMA ACCEL

MDR report key: 3201174 · Received July 2, 2013

Report

Report Number
1722028-2013-01271
Event Type
Malfunction
Date Received
July 2, 2013
Date of Event
April 19, 2013
Report Date
June 7, 2013
Manufacturer
TERUMO BCT
Product Code
GKT
PMA / PMN Number
BK120017
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION: THE DISPOSABLE SET WAS UNAVAILABLE FOR RETURN AND INVESTIGATION. THE DEVICE HISTORY RECORDS (DHR) WERE REVIEWED FOR THIS LOT. THERE WERE NO ISSUES NOTED IN THE DHR THAT WOULD CONTRIBUTE TO THE ELEVATED WBC COUNT THAT THE CUSTOMER EXPERIENCED. THE RUN DATA FILE WAS ANALYZED FOR THIS EVENT. ROOT CAUSE: THE ANALYSIS OF THE RUN DATA FILE INDICATES IT IS POSSIBLE THAT THE PLASMA LINE MAY HAVE BEEN OCCLUDED DURING A PORTION OF THE PROCEDURE. IF THE PLASMA LINE DOES NOT CONTRIBUTE PROPERLY TO THE PLATELET PUMP IT IS POSSIBLE THE FLOW THROUGH THE LRS CHAMBER COULD BE HIGHER THAN EXPECTED BY THE SYSTEM. THIS COULD ALLOW SOME WBCS TO ESCAPE AND CONTRIBUTE TO THE HIGHER THAN EXPECTED WBC CONTENT REPORTED FOR THIS COLLECTION. IMPROPER DISPOSABLE KIT LOADING MAY CONTRIBUTE TO THE ABOVE. CORRECTIVE/PREVENTIVE ACTION: AN INTERNAL CAPA HAS BEEN INITIATED TO EVALUATE REPORTS OF ELEVATED RWBCS RELATED TO PLASMA LINE OCCLUSIONS.

Description of Event or Problem · 1

THE CUSTOMER WOULD LIKE THE RUN DATA FILE INVESTIGATED TO DETERMINE A POSSIBLE CAUSE FOR THE ELEVATED WHITE BLOOD CELL (WBC) CONTENT IN THE PLATELET PRODUCT. THERE WAS NOT A TRANSFUSION RECIPIENT OR PATIENT INVOLVED AT THE TIME OF THE RESIDUAL WBC TESTING, THEREFORE NO PATIENT INFORMATION IS REASONABLY KNOWN AT THE TIME OF THE EVENT. DONOR UNIT #: (B)(6) THE DISPOSABLE SET IS UNAVAILABLE FOR RETURN BECAUSE THE CUSTOMER DISCARDED IT. THIS REPORT IS BEING FILED DUE TO A DEVICE MALFUNCTION THAT HAS THE POTENTIAL FOR INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
303484 TRIMA ACCEL TRIMA ACCEL ENHANCED PLATELET, PLASMA, RBC SET GKT TERUMO BCT 03V1213

Patients

Seq Age Sex Outcome Treatment
1 Other