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Catalog Number PMX110 |
Device Problems
Contamination (1120); Device Handling Problem (3265)
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Patient Problem
No Consequences Or Impact To Patient (2199)
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Event Date 09/06/2018 |
Event Type
malfunction
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Manufacturer Narrative
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Results: dried blood was present on the device housing.Blood was present inside the vacuum pump; therefore, functional testing was not performed.Conclusions: evaluation of the returned pump max confirmed a device with blood inside the vacuum pump.This is likely a result of the reported incorrect connection of the aspiration tubing directly to the vacuum inlet instead of the canister supplied by penumbra.If fluid enters the vacuum pump, it may prevent the pump from functioning properly.Penumbra pumps are visually inspected and functionally test during incoming quality inspection.The manufacturing records for this lot were reviewed and did not reveal any outstanding discrepancies, design, or quality concerns.
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Event Description
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The patient was undergoing a thrombectomy procedure using a penumbra system aspiration pump max 110v (pump max).During the procedure, a hospital staff accidentally connected an indigo system aspiration catheter d (catd) directly to the pump max rather than the canister.Consequently, blood was aspirated into the pump max; therefore, it was disconnected.The procedure was completed using a standard balloon angioplasty.It should be noted that there was no noted damage to the catd.Additionally, there was no report of an adverse effect to the patient.
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Search Alerts/Recalls
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