LIFEPORT KIDNEY PUMP LKT100

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-04-23 for LIFEPORT KIDNEY PUMP LKT100 manufactured by Organ Recovery Systems, Inc..

Event Text Entries

[143205224] Lifeport kidney pump malfunction: the right kidney for organ donor (b)(6) was placed on the lifeport kidney pump on (b)(6) 2019. On (b)(6) 2019 at 1700 a red flashing error light was observed on the pump but no alarm sounding. The pump info was downloaded and it appeared that the pump stopped pumping at 1555. The kidney was taken off the pump, but when the cassette was opened, there was no visible fluid in the cassette. We do not know how long the kidney was not in cold solution storage and cold storage should be the backup mode for any pump failure. Therefore, the kidney was declined for transplant and resulted in a discard of the organ. Add'l info: upon further investigation of the pump, there was only about an inch of mps in the bottom of the cassette, the rest of the solution was under the ice bucket and coming out from the bottom of the machine. Once we identified the issue and took everything apart, we also flushed the cassettes to see if there were any leaks. We could not identify any leaks in the cassettes. We also tipped the machine on the side and found fluid coming out between the top and bottom of the pump. We called the lifeport perfusion hotline and they sent a form for us to fill out and instructed up to send the pump and cassette for further device investigation. The pump and cassettes were sent to lifeport for inspection (b)(6) 2019. This event was also reported to (b)(6) as a pt safety event (event #(b)(6)) on (b)(6) 2019. Fda safety report id# (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5086095
MDR Report Key8545362
Date Received2019-04-23
Date of Report2019-04-19
Date of Event2019-04-10
Date Added to Maude2019-04-24
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag0
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Sequence Number: 1

Brand NameLIFEPORT KIDNEY PUMP
Generic NameSYSTEM, PERFUSION, KIDNEY
Product CodeKDN
Date Received2019-04-23
Returned To Mfg2019-04-12
Model NumberLKT100
Lot Number73588264
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerORGAN RECOVERY SYSTEMS, INC.
Manufacturer AddressUS

Device Sequence Number: 2

Brand NameCASSETTE
Generic NameSYSTEM, PERFUSION, KIDNEY
Product CodeKDN
Date Received2019-04-23
Model NumberLKT200
Device Availability*
Device Eval'ed by MfgrI
Device Sequence No2
Device Event Key0
ManufacturerORGAN RECOVERY SYSTEMS, INC.
Manufacturer AddressUS


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2019-04-23

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