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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZOLL CIRCULATION, INC. QUATTRO® INTRAVASCULAR HEAT EXCHANGE CATHETER KIT CUSTOM LUER APPLAUSE (HEPARIN); INTRAVASCULAR CORE TEMPERATURE REGULATION SYSTEM CATHETER

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ZOLL CIRCULATION, INC. QUATTRO® INTRAVASCULAR HEAT EXCHANGE CATHETER KIT CUSTOM LUER APPLAUSE (HEPARIN); INTRAVASCULAR CORE TEMPERATURE REGULATION SYSTEM CATHETER Back to Search Results
Model Number IC-4593
Medical Device Problem Codes Fluid/Blood Leak (1250); Material Integrity Problem (2978)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/25/2024
Type of Reportable Event Malfunction
Event or Problem Description
The quattro catheter (lot # unknown) was utilized to provide ivtm therapy to a patient.The catheter had been inserted into the right femoral vein.About 16 hours after the initiation of the treatment, the 500-ml saline bag was noted as empty.No saline fluid was observed near the console or the patient, and no thermogard console alarm was activated.Zoll tech support suspected a catheter leak, advising the customer to consider catheter removal at the physician's discretion.The physician expressed interest in discontinuing therapy and transitioning to passive rewarming; however, due to shift change, the catheter remained in place.No consequences or impact to the patient.
 
Additional Manufacturer Narrative
The quattro catheter involved in the reported complaint was not returned to zoll for evaluation.A supplemental report will be filed if and when the product is returned and investigation has been completed.
 
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Brand Name
QUATTRO® INTRAVASCULAR HEAT EXCHANGE CATHETER KIT CUSTOM LUER APPLAUSE (HEPARIN)
Common Device Name
INTRAVASCULAR CORE TEMPERATURE REGULATION SYSTEM CATHETER
Manufacturer (Section D)
ZOLL CIRCULATION, INC.
2000 ringwood ave.
san jose CA 95131
Manufacturer (Section G)
ZOLL CIRCULATION, INC.
2000 ringwood ave.
san jose CA 95131
Manufacturer Contact
kimthoa sackrison
2000 ringwood ave.
san jose, CA 95131
MDR Report Key19956917
Report Number3010617000-2024-00640
Device Sequence Number8810499
Product Code NCX
UDI-Device Identifier00849111075282
UDI-Public00849111075282
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
K101987
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 08/09/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model NumberIC-4593
Device Catalogue Number8700-0783-01
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/25/2024
Initial Report FDA Received Date08/10/2024
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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