FDA Adverse Event Malfunction Summary report: N

CAREFUSION

MDR report key: 4438114 · Received January 17, 2015

Report

Report Number
2021710-2015-00081
Event Type
Malfunction
Date Received
January 17, 2015
Date of Event
December 17, 2014
Report Date
December 17, 2014
Manufacturer
CAREFUSION
Product Code
BTY
PMA / PMN Number
K981366
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CAREFUSION SUBMITTED MEDWATCH REPORT #2021710-2015-00005 ON (B)(4) 2015 REGARDING THE FIRST PATIENT EVENT MENTIONED. THIS MEDWATCH REPORT CONCERNS THE SECOND PATIENT EVENT THAT CAREFUSION BECAME AWARE OF ON (B)(4) 2014. THE USER FACILITY DID NOT SUBMIT A USER FACILITY REPORT TO THE MFR. EVENT CODES WERE DERIVED BASED ON INFO PROVIDED BY THE USER FACILITY REP(S). (B)(4). THE FOLLOWING INFO CONCERNING THE EVALUATION OF THE DEVICE IS A SUMMARY OF THE INFO DOCUMENTED BY THE CAREFUSION FIELD SERVICE REP. THE CAREFUSION FIELD SERVICE REP EVALUATED THE DEVICE AND IN CONSULTATION WITH A CAREFUSION TECH SUPPORT REP DETERMINED THAT THE MOST LIKELY CAUSE OF THE REPORTED EVENT WAS AN ISSUE WITH THE MODEL: TMX425C TREADMILL, SN: FV-(B)(4) MANUFACTURED BY FULL VISION INC. THE CAREFUSION FIELD SERVICE REP ADVISED THE USER FACILITY TO CONTACT FULL VISION INC. AND HAVE THEM COME IN AND EVALUATE THE TREADMILL. CAREFUSION CONTACTED FULL VISION INC. AND THEY CONFIRMED THAT THE TMX425C TREADMILL, SN: FV-(B)(4) WAS MANUFACTURED ON 12/31/2001. THEY FURTHER STATED THAT THIS PRODUCT THAT IS NO LONGER MANUFACTURED BY THEM THOUGH IT IS STILL BEING SERVICED BY THEM AND IS NOT YET OBSOLETE. THE FULL VISION REP INDICATED THAT AN INTERMITTENT INTERFACE CABLE CAN CAUSE SPEED CHANGES AND RECOMMENDED THAT THE USER FACILITY HAVE THE TREADMILL CALIBRATED. FOR CUSTOMER SATISFACTION, CAREFUSION HAS SHIPPED THE USER FACILITY A NEW TREADMILL AND RECOMMENDED THAT THEY TAKE THE OLD TREADMILL OUT OF SERVICE.

Description of Event or Problem · 1

THE FOLLOWING INFO CONCERNING THE EVENT WAS DOCUMENTED BY CAREFUSION REP(S) IN RESPONSE TO PHONE CONVERSATION(S) WITH A CAREFUSION CLINICAL OPERATIONS MGR AND USER FACILITY REP(S). "[NAME REMOVED] CALLED IN STATES THE ACCOUNT IS COMPLAINING THE TM SPEEDS UPS AND RUNS TO FAST SAID THEY TALKED TO SOMEONE IN TECH SUPPORT??? [NAME REMOVED] HAS CHECKED THE PROTOCOLS THE ARE FINE [NAME REMOVED] STATES HE DID NOT SEE THIS HAPPEN". "SPOKE TO DR. SAYS HE THINKS IT IS A PEDS TM TM 425C SN (B)(4) SAYS THIS IS AN OLDER TM NOT THE SN IN OUR DATABASE MAYBE THE ITM NEEDS A FIRMWARE UPGRADE USING MPH AND NOT KPM SEES TM SPEED AS DOUBLED KIDS HAVE ALMOST BEEN THROWN OFF DR STATES IF THIS HAPPEN ONCE MORE HE IS GOING TO CLOSE THE LAB DOWN SAYS THIS HAPPENED AFTER THE WIN7 UPGRADE". "THE CUSTOMER ADVOCATE MGR HAD A PHONE CONVERSATION WITH [NAME REMOVED] THE NURSE MGR AT THE USER FACILITY REGARDING THE TREADMILL ISSUE. NEITHER PATIENT (DESPITE BEING IN A COMPROMISED CARDIOVASCULAR AND/OR PULMONARY STATE) WAS HARMED AT THE TIME THE RAMP-UP OCCURRED. NO MEDICAL INTERVENTION WAS REQUIRED AT THE TIME. THE PATIENTS WERE BOTH ASSISTED OFF OF THE TREADMILL AND ALLOWED TO REST. ACCORDING TO [NAME REMOVED] NEITHER HAS BEEN TREATED FOR ANY OTHER ADVERSE EVENT RELATED TO THE SITUATION; HOWEVER, THE BELIEF IS THAT SHOULD THIS RECUR IT HAS THE POTENTIAL TO CAUSE HARM (RISK FOR SERIOUS INJURY OR DEATH)".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
42442 CAREFUSION CALCULATOR, PERDICTED VALUES, PULMONARY FUNCTION/B BTY CAREFUSION VMAX ENCORE 29C NA

Patients

Seq Age Sex Outcome Treatment
1 NI CAREFUSION ECGC, SN: (B)(4),| FULL VISION TREADMILL, MODEL: TMX425C, SN: (B)(4)