FDA Adverse Event Malfunction Summary report: N

PHOENIX

MDR report key: 725897 · Received May 10, 2006

Report

Report Number
9616240-2006-00336
Event Type
Malfunction
Date Received
May 10, 2006
Report Date
May 10, 2006
Manufacturer
GAMBRO DASCO
Product Code
FII
PMA / PMN Number
K001156
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
INVALID DATA

Narratives

Additional Manufacturer Narrative · 1

NO PATIENT INJURY WAS REPORTED. INVESTIGATION IS ONGOING 510(K)# IS K001156

Description of Event or Problem · 1

THE CUSTOMER REPORTED BLOOD LOSS FOLLOWING A HIGH VENOUS PRESSURE ALARM. THE VENOUS PRESSURE AT A CERTAIN MOMENT WENT VERY HIGH, THE MACHINE WA ALARMING WITH AIR IN BLOOD. BOTH AIR BUBBLE DETECTOR AND DIAPHRAGM NEUTRAL POSITION PROCEDURE WAS PERFORMED. VENOUS PRESSURE DROPPED TO NORMAL, AND THE TREATMENT COULD GO ON.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PHOENIX HEMODIALYSIS EQUIPMENT FII GAMBRO DASCO PHOENIX NA

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other