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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MARVAO MEDICAL NEXSITE HD STEPPED TIP; HEMODIALYSIS CATHETER

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MARVAO MEDICAL NEXSITE HD STEPPED TIP; HEMODIALYSIS CATHETER Back to Search Results
Catalog Number NEXHD1552801
Device Problem Insufficient Information (3190)
Patient Problems Purulent Discharge (1812); Post Operative Wound Infection (2446)
Event Date 09/14/2016
Event Type  Injury  
Manufacturer Narrative
It was indicated that the device will not be returned for evaluation because the device has been disposed; therefore an analysis of the complaint device could not be completed.A review of the manufacturing documentation confirmed that the lot met the specification requirements.The review found no deviations or non-conformances that would have contributed to the reported complaint.Taking into consideration the evaluation conducted and the details of the complaint, this investigation was assigned the most probable root cause of an anticipated procedural complication.A complaint with a most probable root cause classification of an anticipated procedural complication indicates that a device related root cause does not apply and the complaint is due to a known effect of the procedure.
 
Event Description
The nexsite device was successfully placed on (b)(6) 2016.On (b)(6) 2016, the subject reported to the dialysis unit.The rounding doctor noted that there was a pustule at the catheter site.Wound and blood cultures were taken and antibiotics were started.Treatment for the event included ceftazidime and vancomycin.The device was removed on (b)(6) 2016 for a suspected/confirmed crbsi event.The patient is currently using a new catheter for hd treatment.
 
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Brand Name
NEXSITE HD STEPPED TIP
Type of Device
HEMODIALYSIS CATHETER
Manufacturer (Section D)
MARVAO MEDICAL
innovation in business centre
gmit, dublin road
galway, H91 D CH9
EI  H91 DCH9
Manufacturer Contact
fiona geraghty
innovation in business centre,
gmit, dublin road
galway, galway H91 D-CH 9
EI   H91 DCH 9
91759301
MDR Report Key6050147
MDR Text Key58135337
Report Number3008110587-2016-00032
Device Sequence Number1
Product Code MSD
UDI-Device Identifier05391525640020
UDI-Public(01)05391525640020(17)170201(10)43335
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K121933
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type study
Reporter Occupation Other
Type of Report Initial
Report Date 10/04/2016
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/24/2016
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Physician
Device Expiration Date02/01/2017
Device Catalogue NumberNEXHD1552801
Device Lot Number43335
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Date Manufacturer Received10/04/2016
Date Device Manufactured02/05/2016
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age46 YR
Patient Weight67
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