PRISMAFLEX *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2009-10-10 for PRISMAFLEX * manufactured by Gambro Renal Products, Inc.

Event Text Entries

[21400073] Patient receiving cvvhfd (continuous veno-venous hemodiafiltration) on new prismaflex crrt machine. Placed machine in recirculate mode so patient could go on road trip. When machine in recirculate mode it began alarming various alarms: unable to detect return pressure, effluent bag volume changing, blood pump malfunction, and blood detected in line.
Patient Sequence No: 1, Text Type: D, B5


[21427005] Patient receiving cvvhfd (continuous veno-venous hemodiafiltration) on new prismaflex crrt machine. Placed machine in recirculate mode so patient could go on road trip. When machine in recirculate mode it began alarming various alarms: unable to detect return pressure, effluent bag volume changing, blood pump malfunction, and blood detected in line.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1516366
MDR Report Key1516366
Date Received2009-10-10
Date of Report2009-10-10
Date of Event2009-09-10
Report Date2009-10-10
Date Reported to FDA2009-10-10
Date Added to Maude2009-10-27
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NamePRISMAFLEX
Generic NameHEMODIALYSIS MACHINE, CRRT
Product CodeMQS
Date Received2009-10-10
Model NumberPRISMAFLEX
Catalog Number*
Lot Number*
ID Number*
OperatorNURSE
Device AvailabilityY
Device Age6 MO
Device Sequence No1
Device Event Key0
ManufacturerGAMBRO RENAL PRODUCTS, INC
Manufacturer Address14143 DENVER WEST PARKWAY, SUI LAKEWOOD CO 80401 US 80401


Patients

Patient NumberTreatmentOutcomeDate
10 2009-10-10

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