PERFADEX + THAM SOLUTION

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-06-05 for PERFADEX + THAM SOLUTION manufactured by Xvivo Perfusion.

Event Text Entries

[110360819] Physicians and procurement staff were involved in a lung recovery procedure. The perfadex preservation solution was transported to the facility in a cooler. One bag of solution was infused during the recovery and a second bag was prepped for infusion after the lungs were recovered. After approximately half of the fluid was infused from the second bag, a small hole was discovered in the top portion of the bag. The recovering surgeons were informed about the incident as well as the transplanting surgeon and the decision was made to continue with the procedure. The hole was very small and only a small stream of fluid leaked from the bag when pressure was applied. A report was filed with the united network for organ sharing (unos) pt safety portal. The mfr (xvivo perfusion) has been contacted (and responded quickly) as well. Although the mfr denied any current product recall notices (i had also verified recalls on the fda site), they did state that as of 2018, they have a new bag design that will hopefully eliminate future incidences. We will continue to monitor the pt closely. At present, the pt is recovering without incident. Suspect: yes; primary: yes; product type: drug/biologic. Dose or amount: 2800 ml millilitre(s), frequency: one time, route: intravenous. Strength: na ml millilitre(s). Therapy duration: 20 year. Reason for use: lung preservation during organ recovery.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5077650
MDR Report Key7572968
Date Received2018-06-05
Date of Report2018-06-01
Date of Event2018-05-30
Date Added to Maude2018-06-06
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Sequence Number: 0

Brand NamePERFADEX + THAM SOLUTION
Generic NamePERFADEX + THAM SOLUTION
Product CodeKDN
Date Received2018-06-05
Lot Number600148
Device Expiration Date2019-05-31
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No0
Device Event Key0
ManufacturerXVIVO PERFUSION

Device Sequence Number: 1

Brand NamePERFADEX + THAM SOLUTION
Generic NamePERFADEX + THAM SOLUTION
Product CodeKDN
Date Received2018-06-05
Lot Number600148
Device Expiration Date2019-05-31
Device AvailabilityN
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerXVICO PERFUSION


Patients

Patient NumberTreatmentOutcomeDate
101. Congenital Not Applicablenomaly 2018-06-05

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