inforMED
InjuryDXT

ACIST

Received Jul 15, 2025 · Event occurred Jun 15, 2025

Report 2134243-2025-00012 · MDR key 22512245

Device

Generic name

Injector And Syringe, Angiographic

Model number

CVI

Catalog number

014657

Product problems

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

Patient

71 YR · Unknown

  • Air Embolism
  • Air Embolism

Narrative

Additional Manufacturer Narrative

A2: NO PATIENT INFORMATION PROVIDED. THE PATIENT DATE OF BIRTH IS NOT KNOWN AND IS ESTIMATED. THE ACIST ANGIOGRAPHIC INJECTION SYSTEM, MODEL CVI, SERIAL NUMBER (B)(6) HAS NOT YET BEEN RETURNED TO ACIST. THE CONSUMABLES USED DURING THE EVENT WERE DISCARDED BY THE USER FACILITY AND THE LOT NUMBERS ARE NOT KNOWN. THE CINE-ANGIOGRAMS HAVE NOT BEEN RETURNED FOR EVALUATION. UPON COMPLETION OF THE INVESTIGATION, ACIST WILL SUBMIT A FOLLOW-UP REPORT.

Description of Event or Problem

DURING A CORONARY ANGIOGRAPHY, A STUDENT DOCTOR INJECTED AIR INTO THE PATIENT UPON THE LAST INJECTION OF CONTRAST MEDIA. THE PATIENT FLATLINED FOR 30 SECONDS, AFTER WHICH THE PATIENT BECAME RESPONSIVE AND WAS AWARE. ACCORDING TO THE USER FACILITY, THE AIR INJECTION WAS DUE TO USER ERROR. THE USER FACILITY REPORTED THAT THEY HAVE A CINE-ANGIOGRAM OF THE PROCEDURE THEY WILL EMAIL TO ACIST.