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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SMITHS MEDICAL, ASD, INC. PORTEX® SPINAL ANESTHESIA TRAY; ANESTHESIA CONDUCTION KIT

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SMITHS MEDICAL, ASD, INC. PORTEX® SPINAL ANESTHESIA TRAY; ANESTHESIA CONDUCTION KIT Back to Search Results
Catalog Number A4037-25
Device Problem Degraded (1153)
Patient Problem Awareness during Anaesthesia (1707)
Event Date 11/29/2017
Event Type  malfunction  
Manufacturer Narrative
See mfr: 3012307300-2017-2535.
 
Event Description
It was reported that there was questionable potency (of marcaine) in face of a single pass easy placement of a spinal needle from a portex® spinal anesthesia tray.The patient had no motor block and required more intra-operative medications.This is consistent with bad marcaine.Marcaine is a local anesthetic.No adverse events were reported.
 
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Brand Name
PORTEX® SPINAL ANESTHESIA TRAY
Type of Device
ANESTHESIA CONDUCTION KIT
Manufacturer (Section D)
SMITHS MEDICAL, ASD, INC.
6000 nathan lane north
minneapolis MN 55442
Manufacturer (Section G)
SMITHS MEDICAL NORTH AMERICA
10 bowman drive
keene NH 03431 0724
Manufacturer Contact
dave halverson
6000 nathan lane north
minneapolis, MN 55442
7633833310
MDR Report Key7106138
MDR Text Key94655393
Report Number3012307300-2017-02536
Device Sequence Number1
Product Code CAZ
UDI-Device Identifier20351688080339
UDI-Public20351688080339
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 01/23/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/11/2017
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Physician
Device Expiration Date03/01/2019
Device Catalogue NumberA4037-25
Device Lot Number3516651
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Date Manufacturer Received01/06/2018
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured10/17/2017
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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