MAUDE MDR 5125236

MDR report key
5125236
Report number
9680841-2015-00413
Event key
0
Event type
3
Date of event
2015-07-16
Date received
2015-10-02
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
CARRIE WOOD
Address
14401 W 65TH WAY ARVADA CO 80004 US
Phone
303-303-3034
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1XTRAAUTOTRANSFUSION SYSTEMSSORIN GROUP ITALIADTNN/A042511503170114N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12015-10-020

Event Narratives#

N

Patient 1

PATIENT INFORMATION WAS NOT PROVIDED. SORIN GROUP (B)(4) MANUFACTURES THE XTRA DISPOSABLE. THE INCIDENT OCCURRED IN (B)(6). THIS MEDWATCH REPORT IS BEING FILED ON BEHALF OF SORIN GROUP (B)(4). SORIN GROUP RECEIVED A REPORT THAT SAMPLES TAKEN FROM BLOOD PROCESSED USING AN XTRA AUTOTRANSFUSION DEVICE SHOWED HEMOLYSIS. IT WAS ALSO REPORTED THAT THE PATIENT EXPERIENCED HYPOTENSION BUT THERE WAS NO INJURY. A REPORT AGAINST THE EQUIPMENT WAS FILED UNDER MEDWATCH NUMBER 9611109-2015-00346. THE INVESTIGATION IS ONGOING. A FOLLOW-UP REPORT WILL BE SENT WHEN THE INVESTIGATION IS COMPLETE.

D

Patient 1

SORIN GROUP RECEIVED A REPORT THAT SAMPLES TAKEN FROM BLOOD PROCESSED USING AN XTRA AUTOTRANSFUSION DEVICE SHOWED HEMOLYSIS. IT WAS ALSO REPORTED THAT THE PATIENT EXPERIENCED HYPOTENSION BUT THERE WAS NO INJURY.

N

Patient 1

SORIN GROUP (B)(4) MANUFACTURES THE XTRA DISPOSABLE. THE INCIDENT OCCURRED IN (B)(6). THIS MEDWATCH REPORT IS BEING FILED ON BEHALF OF SORIN GROUP (B)(4). SORIN GROUP RECEIVED A REPORT THAT SAMPLES TAKEN FROM BLOOD PROCESSED USING AN XTRA AUTOTRANSFUSION DEVICE SHOWED HEMOLYSIS. IT WAS ALSO REPORTED THAT THE PATIENT EXPERIENCED HYPOTENSION BUT THERE WAS NO INJURY. A REPORT AGAINST THE EQUIPMENT WAS FILED UNDER MEDWATCH NUMBER 9611109-2015-00346. THE DEVICE WAS NOT RETURNED TO SORIN GROUP FOR INVESTIGATION, BUT AN INVESTIGATION WAS PERFORMED BY THE CUSTOMER. FOLLOW-UP COMMUNICATION WITH THE CUSTOMER HAS REVEALED THAT THE REPORTED ISSUE WAS UNRELATED TO THE XTRA AUTOTRANSFUSION DEVICE AND THE DISPOSABLE. A PATHOLOGIST ANALYZED THE CELL SAVER BLOOD AND WAS ABLE TO RULE OUT ANY ISSUES WITH THE BLOOD. AFTER A FULL INVESTIGATION, THE FACILITY CONCLUDED THAT THE ISSUE EXPERIENCED BY THE PATIENT WAS NOT RELATED TO CELL SALVAGE. THE PATIENT WAS ON ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS AT THE TIME OF THE EVENT, WHICH ARE WIDELY USED AS TREATMENT FOR HYPERTENSION. HYPOTENSION IS A POTENTIAL SIDE EFFECT OF THE USE OF THESE DRUGS. A REVIEW OF THE DHR WAS UNABLE TO IDENTIFY ANY CONCESSIONS, DEVIATIONS OR NON-CONFORMITIES RELEVANT TO THE REPORTED FAILURE. NO TRENDS WAS IDENTIFIED FOR THIS TYPE OF ISSUE; THIS IS THE FIRST REPORT OF POTENTIAL CORRELATION BETWEEN HYPOTENSION AND THE USE OF THE XTRA MACHINE AND DISPOSABLES. SORIN GROUP (B)(4) WILL CONTINUE TO MONITOR THE MARKET FOR TRENDS RELATED TO THIS ISSUE. INVESTIGATION PERFORMED BY CUSTOMER.