FDA Adverse Event Malfunction Summary report: N

PULSIOCATH PICCO MONITORING KIT

MDR report key: 4973765 · Received July 22, 2015

Report

Report Number
3003263092-2015-00002
Event Type
Malfunction
Date Received
July 22, 2015
Date of Event
May 16, 2015
Report Date
January 23, 2020
Manufacturer
PULSION MEDICAL SYSTEMS SE
Product Code
KRB
PMA / PMN Number
K020587
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHARMACIST

Narratives

Additional Manufacturer Narrative · 1

ACCORDING TO REC'D INFO THE DEVICE WAS DISCARDED BY THE USER & IS NOT AVAILABLE FOR INVESTIGATION. FURTHER INFO SURROUNDING THE EVENT HAS BEEN SOUGHT. A SUPPLEMENTAL MEDWATCH REPORT WILL BE SENT WHEN THE INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT AFTER ONE HOUR OF USING A PICCO MONITORING KIT ON A PATIENT, A STERILE FLUIDS LOSS AND AN ARTERIAL BLOOD RETURN IN THE PRESSURE LINE AND ON THE GROUND WERE OBSERVED. TWO TUBING CONNECTORS OF THE PRESSURE TRANSDUCER WERE FOUND LOOSE. THE LOOSE CONNECTORS WERE TIGHTENED BUT A NEW LOOSE CONNECTION WAS NOTICED DURING SAMPLING. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
474145 PULSIOCATH PICCO MONITORING KIT PROBE, THERMODILUTION KRB PULSION MEDICAL SYSTEMS SE

Patients

Seq Age Sex Outcome Treatment
1 70 YR