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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 E; INTRAVASCULAR CORE TEMPERATURE REGULATION SYSTEM CATHETER

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ZOLL CIRCULATION, INC QUATTRO® INTRAVASCULAR HEAT EXCHANGE CATHETER KIT CUSTOM LUER APPLAUSE HEPARIN E; INTRAVASCULAR CORE TEMPERATURE REGULATION SYSTEM CATHETER Back to Search Results
Model Number IC-4593AE
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 01/19/2025
Type of Reportable Event Malfunction
Event or Problem Description
The customer reported the quattro catheter (lot unknown) has a leak.The catheter was smoothly inserted on the first attempt into the right femoral vein of an 84 kg male patient.The leak was spotted sometime after insertion because the red pinwheel on the start-up kit (suk) didn´t rotate and the saline solution volume had decreased.No leaked fluid was observed on or around the console or patient.The dwell time is unknown.The customer performed a leak check per ifu and removed the catheter.They spotted a leak and accidentally threw the catheter away.It was replaced with a new catheter without any problems.No impact or consequence to the patient.
 
Additional Manufacturer Narrative
The quattro catheter involved in the reported complaint will not be returned for evaluation because the customer has disposed of it.Therefore physical investigation could not be performed and the root cause could not be determined.
 
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Brand Name
QUATTRO® INTRAVASCULAR HEAT EXCHANGE CATHETER KIT CUSTOM LUER APPLAUSE HEPARIN E
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
4084192922
MDR Report Key21315600
Report Number3010617000-2025-00104
Device Sequence Number8214032
Product Code NCX
UDI-Device Identifier00849111075275
UDI-Public00849111075275
Combination Product (Y/N)N
Initial Reporter CountryAU
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 Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 02/05/2025
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-4593AE
Device Catalogue Number8700-0783-40
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/22/2025
Initial Report FDA Received Date02/05/2025
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 SexMale
Patient Weight84 KG
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