OPTIVANTAGE DH 844001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-10-09 for OPTIVANTAGE DH 844001 manufactured by Liebel-flarsheim.

Event Text Entries

[123366132] Overall investigation summary is as follows: incident: extravasation event. Inspection of equipment requested. Regional service completed general inspection of injector, conducted performance tests according to protocol and verified flow rate & pressure limits were within permitted range. Service stated the "reported problem is attributable to bad connection to patient. No pressure problems found. Equipment is operational. " the injector does not have the capability to prevent or detect an extravasation (infiltration). However, precautions to minimize an extravasation are provided in the operator's manual. Additionally, described in the manual are i. V. Site patency check techniques, including a manual method and another using a patency key in the setup screen. Cts history search shows no other similar issues with this unit. Root/probable cause code is as follows: personnel - performance - failed to follow procedure - service stated the "reported problem is attributable to bad connection to patient. No pressure problems found. Equipment is operational. " no further investigation needed at this time. Qa will continue to monitor and trend for similar issues. No capa at this time, these trends and issues are reported on during quality metrics reviews and during the management review meetings to consider input for corrective action. Disposition summary is as follows: service conducted performance and verified flow rate & pressure limits were within permitted range. Service stated the "reported problem is attributable to bad connection to patient. No pressure problems found. Equipment is operational. "
Patient Sequence No: 1, Text Type: N, H10


[123366133] This incident was reported by a distributor on (b)(4) 2018, as an lfi optivantage extravasation and an inspection of the device was requested. The reporter stated that this event occurred during a procedure, which was not completed, and resulted in the injury of a patient. There was no error codes that presented during the incident. A general inspection of the injector was completed by regional service, including performance tests according to protocol, verified flow rate and pressure limits were within range permitted. The reported problem is attributed to bad connection to patient, and no pressure problems were found, deeming the equipment as operational.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1518293-2018-00039
MDR Report Key7947147
Date Received2018-10-09
Date of Report2018-09-11
Date of Event2018-09-11
Date Mfgr Received2018-09-05
Device Manufacturer Date2012-03-31
Date Added to Maude2018-10-09
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 ContactFRED RECKELHOFF
Manufacturer Street2111 E GALBRAITH ROAD
Manufacturer CityCINCINNATI OH 45237
Manufacturer CountryUS
Manufacturer Postal45237
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameOPTIVANTAGE DH
Generic NameOPTIVANTAGE DH
Product CodeIZQ
Date Received2018-10-09
Model Number844001
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerLIEBEL-FLARSHEIM
Manufacturer Address2111 E GALBRAITH ROAD CINCINNATI OH 45237 US 45237


Patients

Patient NumberTreatmentOutcomeDate
10 2018-10-09

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