MAHURKAN 11.5 FR X 19.5 CM DVAL LUMAN CATHETER 15668-001 N/A

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1992-02-19 for MAHURKAN 11.5 FR X 19.5 CM DVAL LUMAN CATHETER 15668-001 N/A manufactured by Quinton.

Event Text Entries

[16271196] Patient was 56 year old female with history of hypertension, cardiomegaly and concentric lvh and chronic renal insufficiency requiring hemodialysis. The patient was admitted for outpatient placement of a perma-cath dialysis access catheter. The patient had an injury from dilator in the infraclavicular subclavian vein on the right which caused exsanguination into the chest cavity. Despite placement of tube thoracostomy and attempted resuscitation with blood and the patient's salvaged bloodd from the chest tube, and multiple cardiac drugs in attempt to resuscitate, the patient expired on the or table secondary to exsanguination of the chest cavity from an injury of the infraclavicular vein by a dilator used for placement of a perma-cath. Event not report as "product related" until 1/21/92device labeled for single use. Patient medical status prior to event: fair condition. There was not multiple patient involvement. Invalid data - on device service/maintenance. No data - regarding date last serviced. Service provided by: invalid data. Invalid data - service records availability. No imminent hazard to public health claimed. Device used as labeled/intended. Device was evaluated after the event. Method of evaluation: actual device involved in incident was evaluated, visual examination. Results of evaluation: inherent risk of procedure, unanticipated adverse reaction - short term. Conclusion: no data. Certainty of device as cause of or contributor to event: maybe. Corrective actions: use of all similar devices stopped temporarily. The device was not destroyed/disposed of.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number378
MDR Report Key378
Date Received1992-02-19
Date of Report1992-02-05
Report Date1992-02-05
Date Reported to FDA1992-02-05
Date Reported to Mfgr1991-02-05
Date Added to Maude1992-04-21
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameMAHURKAN 11.5 FR X 19.5 CM DVAL LUMAN CATHETER
Generic NameQUINTON CATHETER, PERMA-CATH (RENAL CATHETER)
Product CodeFFE
Date Received1992-02-19
Model Number15668-001
Catalog NumberN/A
Lot NumberUNKNOWN
ID NumberP/N 018149-1358
OperatorOTHER HEALTH CARE PROFESSIONAL
Device AvailabilityY
Implant FlagY
Device Sequence No1
Device Event Key372
ManufacturerQUINTON


Patients

Patient NumberTreatmentOutcomeDate
101. Death 1992-02-19

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