FDA Adverse Event Injury Summary report: N

LIBERTY CYCLER

MDR report key: 3821287 · Received May 9, 2014

Report

Report Number
2937457-2014-00800
Event Type
Injury
Date Received
May 9, 2014
Date of Event
April 8, 2014
Report Date
April 10, 2014
Manufacturer
FRESENIUS MEDICAL CARE NORTH AMERICA
Product Code
FKX
PMA / PMN Number
K043363
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF THE PHYSICIAN'S ASSESSMENT OF THE REPORTED INFO AND COMPLETION OF THE PLANT'S INVESTIGATION.

Description of Event or Problem · 1

A PERITONEAL DIALYSIS (PD) NURSE REPORTED THAT DURING A ROUTINE VISIT WITH THE PRIMARY CARE PHYSICIAN, THE PT WAS FOUND TO HAVE LOW BLOOD PRESSURE. THE PT WAS HOSPITALIZED FROM (B)(6) 2014. NO FURTHER INFO WILL BE PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
282138 LIBERTY CYCLER FKX FRESENIUS MEDICAL CARE NORTH AMERICA

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization