FDA Adverse Event Other Summary report: N

PEDIA SAT OXIMETRY CATHETER

MDR report key: 793550 · Received November 30, 2006

Report

Report Number
6000002-2006-00691
Event Type
Other
Date Received
November 30, 2006
Date of Event
November 2, 2006
Report Date
November 3, 2006
Manufacturer
EDWARDS LIFESCIENCES
Product Code
DQE
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

H6: DEVICE WAS NOT RETURNED OR EVALUATION.H6. DEVICE WAS NOT RETURNED FOR EVAL.

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WAS A TWO-MINUTE RUN OF SUPRAVENTRICULAR TACHYCARDIA MOST LIKELY CAUSED BY THE GUIDEWIRE (40 CM X 0.018) BEFORE INSERTING THE PEDIASAT CATHETER. IT WAS STATED THAT IT WAS RESOLVED WITH ONE DOSE OF LIDOCAINE. PT WAS FINE AFTERWARD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PEDIA SAT OXIMETRY CATHETER OXIMETRY CATHETER DQE EDWARDS LIFESCIENCES XT245HS UNK

Patients

Seq Age Sex Outcome Treatment
1 3 MO Other