FDA Adverse Event Injury Summary report: N

HLS-SET OR PLS -SET

MDR report key: 4276152 · Received November 18, 2014

Report

Report Number
8010762-2014-01230
Event Type
Injury
Date Received
November 18, 2014
Report Date
October 29, 2014
Manufacturer
MAQUET CARDIOPULMONARY AG
Product Code
DTQ
PMA / PMN Number
NI
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS NOT AVAILABLE FOR EVAL. A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED IF ADDITIONAL INFO BECOMES AVAILABLE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THREE PTS DEVELOPED PARALYSIS DURING IABP (INTRA-AORTIC BALLOON PUMP) AND ECMO (EXTRA CORPOREAL MEMBRANE OXYGENATION) COMBINED. THIS IS PT 2 OF 3, REFER TO MFG REPORT # 8010762-2014-01229 AND 8010762-2014-01231 FOR THE OTHER TWO PTS. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
745732 HLS-SET OR PLS -SET NONE DTQ MAQUET CARDIOPULMONARY AG

Patients

Seq Age Sex Outcome Treatment
1 Disability