MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2017-05-05 for PRISMAFLEX TPE 107144 manufactured by Gambro Industries.
[74580402]
(b)(4).
Patient Sequence No: 1, Text Type: N, H10
[74580403]
A patient was receiving therapeutic plasma exchange (tpe) using a prismaflex tpe 2000 set and a prismaflex control unit for the second time. Shortly after treatment start, when the infusion of albumin was started, the patient presented with erythema of the trunk and the face, bilateral back pains and severe chest pains. No additional information is available.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 8010182-2017-00026 |
| MDR Report Key | 6547898 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2017-05-05 |
| Date of Report | 2017-05-05 |
| Date of Event | 2017-04-04 |
| Date Mfgr Received | 2017-04-12 |
| Date Added to Maude | 2017-05-05 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Street | 25212 W. ILLINOIS ROUTE 120 |
| Manufacturer City | ROUND LAKE IL 60073 |
| Manufacturer Country | US |
| Manufacturer Postal | 60073 |
| Manufacturer Phone | 2242702068 |
| Manufacturer G1 | GAMBRO INDUSTRIES |
| Manufacturer Street | 7 AVENUE LIONEL TERRAY |
| Manufacturer City | MEYZIEU |
| Manufacturer Country | FR |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PRISMAFLEX TPE |
| Product Code | MDP |
| Date Received | 2017-05-05 |
| Model Number | NA |
| Catalog Number | 107144 |
| Lot Number | 16K1704 |
| Device Expiration Date | 2019-11-01 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | GAMBRO INDUSTRIES |
| Manufacturer Address | 7 AVENUE LIONEL TERRAY MEYZIEU 69883 FR 69883 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2017-05-05 |