FDA Adverse Event Injury Summary report: N

PROSORBA COLUMN

MDR report key: 470053 · Received July 2, 2003

Report

Report Number
3032792-2003-00002
Event Type
Injury
Date Received
July 2, 2003
Date of Event
June 2, 2003
Report Date
July 1, 2003
Manufacturer
FRESENIUS HEMOCARE, INC.
Product Code
LQQ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

ON WAY HOME AFTER THE FIRST PROSORBA TREATMENT, PT HAD CHEST PAIN. PT WAS HOSPITALIZED AND DIAGNOSED WITH ACUTE MYOCARDIAL INFARCTION. TREATED WITH THROMBOLYTIC MEASURES AND SURVEILLANCE IN ICU. TESTS REVEALED SEVERE CORONARY HEART DISEASE (3-VESSEL) WITH HIGH DEGREE OF STENOSIS OF RIVA, RD I AND II, RCX, AND RCA AND REDUCED GLOBAL FUNCTIONALITY (EJECTION FRACTION OF 34%). NO FURTHER PROSORBA TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROSORBA COLUMN PROSORBA COLUMN LQQ FRESENIUS HEMOCARE, INC. 9798701 NEN011

Patients

Seq Age Sex Outcome Treatment
1 70 YR Life Threatening VIOXX| BISOPROLOL| NALOXON| VOLTAREN| DECORTIN