PRISMAFLEX TPE N/A 107144

MAUDE Adverse Event Report

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 2017-05-15 for PRISMAFLEX TPE N/A 107144 manufactured by Gambro Industries.

Event Text Entries

[75209267] (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[75209268] A patient was treated with therapeutic plasma exchange (tpe), using a prismaflex tpe 2000 set and a prismaflex control unit for the first time. About 15 minutes after treatment start, once the first albumin bag had been infused, the patient reportedly became pale and felt unwell. The patient reportedly presented with a significant blood pressure drop to 70/50 mmhg, and their oxygen saturation was at 90% whereas they had no respiratory history. Treatment was discontinued and the patient received a bolus of 100 ml of isotonic saline solution, which led to an increase of blood pressure to 90/50 mmhg 10 minutes later. The physician suspected a hemolysis without back pain. No additional information is available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8010182-2017-00030
MDR Report Key6568360
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2017-05-15
Date of Report2017-06-22
Date of Event2017-04-05
Date Mfgr Received2017-05-30
Device Manufacturer Date2017-01-01
Date Added to Maude2017-05-15
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 Street25212 W. ILLINOIS ROUTE 120
Manufacturer CityROUND LAKE IL 60073
Manufacturer CountryUS
Manufacturer Postal60073
Manufacturer Phone2242702068
Manufacturer G1GAMBRO INDUSTRIES
Manufacturer Street7 AVENUE LIONEL TERRAY
Manufacturer CityMEYZIEU
Manufacturer CountryFR
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePRISMAFLEX TPE
Product CodeMDP
Date Received2017-05-15
Model NumberN/A
Catalog Number107144
Lot Number17A1806
ID NumberN/A
Device Expiration Date2020-01-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerGAMBRO INDUSTRIES
Manufacturer Address7 AVENUE LIONEL TERRAY MEYZIEU 69883 FR 69883


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-05-15

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