VAC-PAC 51631

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2018-05-08 for VAC-PAC 51631 manufactured by Natus Medical Incorporated.

Event Text Entries

[107691657] Natus qa evaluated the returned vac-pac, which had been repaired with one half of a patch next to the valve stem. The returned vac-pac was suctioned and remained firm for 72 hours. When the patch was removed, the vac-pac softened. A 0. 5cm tear was observed 2. 0cm from the valve stem, and qa suspected that the tear may have been caused by a towel clamp. The complainant opted to replace their vac-pac under warranty. Users are instructed to check the vac-pac device before and after each use and not to use the device if there is known damage or a leak.
Patient Sequence No: 1, Text Type: N, H10


[107691658] Natus received a report that a vac-pac had softened during a lateral shoulder procedure which lasted approximately three hours. The complainant initially noticed that the vac-pac had softened when the patient was placed on it prior to surgery prep. Suction was re-applied, the valve cap was closed, and the vac-pac was subsequently used during surgery. After the surgery, it was noted that the vac-pac had become flaccid. Upon inspection of the vac-pac, a small tear was noticed near the valve and beads originating from the vac-pac were seen on the patient bed. The complainant stated that vac-pacs are stored firm and flat, and they had not noticed a tear prior to surgery. The vac-pac was purchased in (b)(6) 2017. The complainant noted a slipping of an arthrex s3 traction tower during surgery which could have possibly been related to a lack of lateral support provided by the vac-pac. The complainant stated that the patient did not lose position during surgery as the vac-pac was taped to the operating room table and securing posts were attached. There was no report of death, serious injury, delay in treatment, or environmental/safety concerns. The complainant stated that there was no harm caused to the patient.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3018859-2018-00121
MDR Report Key7496931
Report SourceUSER FACILITY
Date Received2018-05-08
Date of Report2018-04-11
Date of Event2018-04-10
Date Mfgr Received2018-04-11
Date Added to Maude2018-05-08
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJAMES FITZGERALD
Manufacturer Street5900 FIRST AVENUE SOUTH
Manufacturer CitySEATTLE WA 98108
Manufacturer CountryUS
Manufacturer Postal98108
Manufacturer Phone2062685173
Manufacturer G1NATUS MEDICAL INCORPORATED
Manufacturer Street5900 FIRST AVENUE SOUTH
Manufacturer CitySEATTLE WA 98108
Manufacturer CountryUS
Manufacturer Postal Code98108
Single Use3
Remedial ActionRL
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameVAC-PAC
Generic NameVAC-PAC
Product CodeCCX
Date Received2018-05-08
Returned To Mfg2018-04-26
Model Number51631
Lot NumberN020617-06
OperatorNURSE
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerNATUS MEDICAL INCORPORATED
Manufacturer Address5900 FIRST AVENUE SOUTH SEATTLE WA 98108 US 98108


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-05-08

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