FDA Adverse Event Death Summary report: N

NATURALYTE

MDR report key: 3840749 · Received May 13, 2014

Report

Report Number
1225714-2014-02572
Event Type
Death
Date Received
May 13, 2014
Report Date
April 17, 2014
Manufacturer
FRESENIUS MEDICAL CARE NORTH AMERICA
Product Code
KPO
PMA / PMN Number
K070177
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# 1225714-2014-02571 AND 1225714-2014-02572.

Additional Manufacturer Narrative · 1

(B)(4). THIS IS ONE EVENT FOR THE SAME PATIENT INVOLVING TWO SEPARATE PRODUCTS, ASSOCIATED MDR #1225714-2014-02571 AND 1225714-2014-02572.

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 WAS RECEIVED IN WHICH THE PLAINTIFF'S ATTORNEY ALLEGED THAT THE PATIENT EXPERIENCED THE FOLLOWING INJURIES: ALKALOSIS, CARDIAC ARRHYTHMIAS, SUDDEN CARDIAC ARREST AND SUBSEQUENTLY EXPIRED. THE EVENT WAS ALLEGED TO HAVE BEEN CAUSED BY THE PRODUCT ADMINISTERED DURING DIALYSIS TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
285484 NATURALYTE KPO FRESENIUS MEDICAL CARE NORTH AMERICA

Patients

Seq Age Sex Outcome Treatment
1 Death