FDA Adverse Event Injury Summary report: N

PORTEX COMBINED SPINAL EPIDURAL ANESTHESIA TRAYS

MDR report key: 3833402 · Received May 19, 2014

Report

Report Number
2183502-2014-00315
Event Type
Injury
Date Received
May 19, 2014
Report Date
May 16, 2014
Manufacturer
SMITHS MEDICAL MD, INC.
Product Code
CAZ
PMA / PMN Number
K965017
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CUSTOMER HAS NOT YET RETURNED THE DEVICE TO THE MANUFACTURER FOR DEVICE EVALUATION. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MANUFACTURER WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION.

Description of Event or Problem · 1

USER FACILITY REPORTED THAT THE DEVICE WAS PLACED IN USE WITH PATIENT AND THE LOSS OF RESISTANCE SYRINGE COMPONENT WAS NOT PROVIDING PROPER FEEDBACK DURING EPIDURAL PLACEMENT. ACCORDING TO REPORTER, PATIENT RECEIVED DURA PUNCTURE. PATIENT RECEIVED AN EPIDURAL BLOOD PATCH AND WAS GIVEN VARIOUS ANALGESIC MEDICATIONS FOR APPROXIMATELY ONE WEEK. NO PERMANENT ADVERSE EFFECTS TO PATIENT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
295771 PORTEX COMBINED SPINAL EPIDURAL ANESTHESIA TRAYS CAZ-ANESTHESIA CONDUCTION CAZ SMITHS MEDICAL MD, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention