FDA Adverse Event Death Summary report: N

BASIC SOLUTION SET & EXTENSION SET

MDR report key: 5331 · Received June 11, 1993

Report

Report Number
5331
Event Type
Death
Date Received
June 11, 1993
Date of Event
March 2, 1993
Report Date
April 16, 1993
Manufacturer
BAXTER
Adverse Event
Yes
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

ON 3/2/93, THE PATIENT WAS SCHEDULED FOR SURGERY. SHORTLY AFTER INDUCTION, THE [ATIENT DEVELOPED BRONCOSPASMS AND THEN CONTINUED INTO A CARDIOVASCULAR AARREST PRESENTING PROFOUND HYPOTENSION. RESUSCITATION MEASURES WERE INITIATED AND THE PATIENT MOVED TO AN INTENSIVE CARE UNIT. THE PATIENT SUBSEQUENTLY EXPIRED ON 3/7/93. PRIOR TO THE PATIENT'S EXPIRATION A SERUM SAMPLE WAS OBTAINED AND SENT FOR LATEX ALLERGY TESTING. THE TEST RESULTS INDICATED A POSITIVE REACTION. AT THAT TIME AN MDR REPORT WAS SUBMITTED TO THE USP LISTING THE TWO MANUFACTURERSDEVICE NOT LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: SATISFACTORY CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY. NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS NOT EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: NO DATA. RESULTS OF EVALUATION: NO DATA. CONCLUSION: NO DATA. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: MAYBE. CORRECTIVE ACTIONS: DEVICE DISCARDED, USER EDUCATION PROVIDED. THE DEVICE WAS DESTROYED/DISPOSED OF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BASIC SOLUTION SET & EXTENSION SET SAME BAXTER NONE UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 48 YR Death