Catalog Number 10226 |
Device Problems
Patient-Device Incompatibility (2682); Adverse Event Without Identified Device or Use Problem (2993); Insufficient Information (3190)
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Patient Problem
Itching Sensation (1943)
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Event Date 07/08/2022 |
Event Type
Injury
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Event Description
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The customer reported that a patient appeared to have an anaphylactic reaction during a tpe procedure.Per the customer, the patient felt pruritus on the face and arms at 16:00.The operator gave the patient 5mg hexadecadrol by intravenous injection per physician order.The patient felt her head was numb at 16:30.The operator gave the patient 10% calcium gluconate 20ml orally.The patient felt pruritus on face, neck and arms at 16:49.The disposable set is not available for return for evaluation.This product is not available within the us, but this report is being filed due to an alleged failure that could occur on a similarly marketed device platform cleared for use by the fda.
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Manufacturer Narrative
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Investigation is in process, a follow-up report will be provided.
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Manufacturer Narrative
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Investigation: a review of the device history record (dhr) for this unit showed no irregularities during manufacturing that were relevant to this issue.The run data file (rdf) was analyzed for this event.There were no signals or alarms in the rdf that would indicate issues during the run, specifically the amount of ac delivered.The commanded ac pump speed and the measured ac pump speed were accurate and did not show any discrepancy in pump volume.According to therapeutic apheresis: a physician's handbook, adverse events occur during therapeutic procedures with a frequency of 4.8%.Symptoms of allergic reactions may include hives, dyspnea, wheezing, burning eyes, tachycardia, hypotension, and or facial swelling and flushing.Mild reactions can be treated with diphenhydramine administered through an iv.Transient hypocalcemia associated with apheresis is usually well tolerated.Symptoms often show as parasethesia (tingling) but patients may also experience unusual taste, nausea, lightheadedness, shivering, and tremors.Severe hypocalcemia may also cause muscle contractions and can progress to tetany and seizures if hypocalcemia escalates and is not corrected.A disposable complaint history search was performed for this lot and found a total of 3 occurrences reported from the same customer (in this complaint record) for similar issues worldwide.Mdr 1722028-2022-00276 and mdr 1722028-2022-00278.The third occurrence was not reportable.Root cause: a root cause assessment was performed for this complaint.Based on customer's statements about the patient reactions possible causes include but are not limited to: * an allergy to replacement solution and/or patient sensitivity to eto * patient disease state and/or patient sensitivity to anticoagulant.
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Event Description
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The customer reported that a patient appeared to have an anaphylactic reaction during a tpe procedure.Per the customer, the patient felt pruritus on the face and arms at 16:00.The operator gave the patient 5mg hexadecadrol by intravenous injection per physician order.The patient felt her head was numb at 16:30.The operator gave the patient 10% calcium gluconate 20ml orally.The patient felt pruritus on face, neck and arms at 16:49.The disposable set is not available for return for evaluation.This product is not available within the us, but this report is being filed due to an alleged failure that could occur on a similarly marketed device platform cleared for use by the fda.
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Event Description
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The customer reported that a patient appeared to have an anaphylactic reaction during a tpe procedure.Per the customer, the patient felt pruritus on the face and arms at 16:00.The operator gave the patient 5mg hexadecadrol by intravenous injection per physician order.The patient felt her head was numb at 16:30.The operator gave the patient 10% calcium gluconate 20ml orally.The patient felt pruritus on face, neck and arms at 16:49.The disposable set is not available for return for evaluation.This product is not available within the us, but this report is being filed due to an alleged failure that could occur on a similarly marketed device platform cleared for use by the fda.
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Manufacturer Narrative
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Investigation is in process, a follow-up report will be provided.
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Search Alerts/Recalls
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