ZOLL IVTM QUATTRO CATHETER IC-4593 8700-0783-01

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-11 for ZOLL IVTM QUATTRO CATHETER IC-4593 8700-0783-01 manufactured by Zoll Circulation.

Event Text Entries

[188219964] The quatrro catheter associated with this complaint was not returned for evaluation. The customer disposed the catheter. Since the device was not returned, an investigation could not be performed and a root cause could not be determined.
Patient Sequence No: 1, Text Type: N, H10


[188219965] After 24 hours of ivtm therapy for hypothermia, the facility's register nurse reported that the thermogard ivtm system generated "air trap" alarm and hospital staff noticed the 500 ml. Saline bag had emptied. The staff checked the tubings and around the thermogard system for fluid leak and did not observed fluid. Staff placed another 500 ml. Saline bag and apparently appeared to be running well, however; the following morning, staff noticed the saline bag had emptied again and the patient wasn't reaching target. Ivtm therapy was discontinued because the patient woke up. Staff removed the quattro catheter (lot #unknown) and disposed it, only the start-up kit (lot #unknown) was saved. The thermogard ivtm system has no malfunction and it is currently in clinical use. Per user, there was no adverse impact on patient due to saline infusion. No consequences or impact to patient was reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3010617000-2020-00255
MDR Report Key9819122
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-11
Date of Report2020-03-10
Date of Event2020-02-14
Date Mfgr Received2020-02-15
Date Added to Maude2020-03-11
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. KIM THOA NGUYEN
Manufacturer Street2000 RINGWOOD AVE.
Manufacturer CitySAN JOSE, CA
Manufacturer CountryUS
Manufacturer Phone4192922
Manufacturer G1ZOLL CIRCULATION
Manufacturer Street2000 RINGWOOD AVE.
Manufacturer CitySAN JOSE, CA
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameZOLL IVTM QUATTRO CATHETER
Generic NameCENTRAL VENOUS CATHETER
Product CodeNCX
Date Received2020-03-11
Model NumberIC-4593
Catalog Number8700-0783-01
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerZOLL CIRCULATION
Manufacturer Address2000 RINGWOOD AVE. SAN JOSE, CA US


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-11

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