FDA Adverse Event Malfunction Summary report: N

PULSION PULSIOCATH THERMODILUTION CATHETERS

MDR report key: 4994983 · Received July 31, 2015

Report

Report Number
3003263092-2015-00007
Event Type
Malfunction
Date Received
July 31, 2015
Date of Event
February 17, 2014
Report Date
February 17, 2014
Manufacturer
PULSION MEDICAL SYSTEMS SE
Product Code
KRB
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TW
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE PICCO CATHETER WAS RETURNED FOR INVESTIGATION. THE REPORTED PROBLEM COULD BE CONFIRMED BY OCULAR INSPECTION. THE CAUSE TO THE DETACHMENT IS SEEN AS A PRODUCTION ERROR. PLEASE NOTE, THIS EVENT IS BEING FILED AS A RETROSPECTIVE MDR AS A RESULT OF A REVIEW OF OUR COMPLAINT DATABASE.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING USE OF A PICCO CATHETER ON A PATIENT, BLOOD BACK FLOW WAS FOUND IN THE CATHETER. NO KNOWN IMPACT OR CONSEQUENCES ON PATIENT. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
501496 PULSION PULSIOCATH THERMODILUTION CATHETERS KRB PULSION MEDICAL SYSTEMS SE

Patients

Seq Age Sex Outcome Treatment
1