FDA Adverse Event Death Summary report: N

GRANUFLO

MDR report key: 3840735 · Received May 13, 2014

Report

Report Number
1225714-2014-02547
Event Type
Death
Date Received
May 13, 2014
Date of Event
July 26, 2011
Report Date
April 17, 2014
Manufacturer
FRESENIUS MEDICAL CARE NORTH AMERICA
Product Code
KPO
PMA / PMN Number
K030497
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

THIS IS ONE EVENT FOR THE SAME PATIENT INVOLVING TWO SEPARATE PRODUCTS; ASSOCIATED MDR # 1225714-2014-02548.

Additional Manufacturer Narrative · 1

(B)(4). THIS IS ONE OF TWO DEVICE REPORTS ASSOCIATED WITH THIS EVENT. ASSOCIATED MFR REPORT #S 1225714-2014-02547 AND 1225714-2014-02548. ADDITIONAL INFORMATION HAS BEEN REQUESTED AND WILL BE SUBMITTED UPON RECEIPT ACCORDINGLY.

Description of Event or Problem · 1

THE PLAINTIFF'S ATTORNEY ALLEGED THE DECEDENT EXPERIENCED AN UNSPECIFIED INJURY AND SUBSEQUENTLY EXPIRED ON AN UNKNOWN DATE AFTER USE OF THE PRODUCT.

Description of Event or Problem · 1

ADDITIONAL INFORMATION RECEIVED ALLEGED THAT THE PATIENT EXPERIENCED ALKALOSIS, CARDIAC ARRHYTHMIAS, SUDDEN CARDIAC ARREST, AND SUDDEN CARDIAC DEATH, WHICH IS ALLEGED TO HAVE BEEN CAUSED BY THE PRODUCT ADMINISTERED DURING DIALYSIS TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
285331 GRANUFLO KPO FRESENIUS MEDICAL CARE NORTH AMERICA

Patients

Seq Age Sex Outcome Treatment
1 Death