inforMED
InjuryPXU

PERCARDIOCENTESIS KIT.STERILE

Received Mar 16, 2022 · Event occurred Mar 2, 2022

Report 1125782-2022-00003 · MDR key 13778738

Device

Generic name

Custom Kit

Catalog number

K10T-05816

Product problems

  • Adverse Event Without Identified Device or Use Problem
  • Adverse Event Without Identified Device or Use Problem

Patient

Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

THE SUSPECT DEVICE WAS NOT RETURNED FOR EVALUATION. THE COMPLAINT COULD NOT BE CONFIRMED. THE ROOT CAUSE COULD NOT BE DETERMINED. A SEARCH OF THE COMPLAINT DATABASE WAS PERFORMED AND NO SIMILAR COMPLAINTS FOR THIS LOT NUMBER WERE FOUND. THE DEVICE HISTORY RECORD WAS REVIEWED, AND NO EXCEPTION DOCUMENTS WERE FOUND.

Description of Event or Problem

THE ACCOUNT ALLEGES THAT THE DEVICE DIDN'T ADEQUATELY DRAIN THE FLUID FROM THE PATIENT'S PAERICARDIAL SACK DURING THE PROCEDURE. THE DEVICE WAS REPLACED WITH ANOTHER AND THE PROCEDURE WAS SUCCESSFULLY COMPLETED. NO ADDITIONAL PATIENT CONSEQUENCE TO REPORT.

Additional Manufacturer Narrative

THE SUSPECT DEVICE IS NOT EXPECTED TO RETURN FOR EVALUATION. A FOLLOW UP WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETE.