FDA Adverse Event Death Summary report: N

MEDRAD MR INJECTOR

MDR report key: 818968 · Received February 15, 2007

Report

Report Number
2520313-2007-00005
Event Type
Death
Date Received
February 15, 2007
Date of Event
January 8, 2007
Report Date
February 15, 2007
Manufacturer
MEDRAD, INC.
Product Code
DXT
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

HOSPITAL INDICATED THAT THE INCIDENT OCCURRED DUE TO ADVERSE REACTION TO CONTRAST MEDIUM. INJECTOR WAS CHECKED AS PART OF MEDRAD'S STANDARD PRACTIVE. MEDRAD SERVICE REPRESENTATIVE CHECKED INJECTOR WITH NO PROBLEMS FOUND WITH THE UNIT.

Description of Event or Problem · 1

HOSPITAL REPORTED SHORTLY AFTER FINISHING MRI OF RENALS USING PROHANCE CONTRAST MEDIUM, THE PATIENT INDICATED HE COULD NOT BREATHE AND WENT INTO CARDIAC ARREST. CPR WAS ATTEMPTED, BUT THE PATIENT EXPIRED. HOSPITAL INDICATED THIS INCIDENT OCCURRED DUE TO AN ADVERSE REACTION TO THE PROHANCE CONTRAST MEDIUM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MEDRAD MR INJECTOR MR INJECTOR DXT MEDRAD, INC. SMR NA

Patients

Seq Age Sex Outcome Treatment
1 NA Death