NXSTAGE SYSTEM ONE NX1000-5 ACUTE CYCLER 3RD ED W/ ONEVIEW

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2020-03-18 for NXSTAGE SYSTEM ONE NX1000-5 ACUTE CYCLER 3RD ED W/ ONEVIEW manufactured by Nxstage Medical, Inc..

Event Text Entries

[188244155] Since manufacture and release of the device in 2016, it has been serviced and maintained at the customer site by their trained and qualified internal facility biomedical engineers. Site records for servicing, maintenance and calibration were not available. The device history record (dhr) was reviewed and confirmed the device met all quality criteria and manufacturing specifications prior to release. Following this event, the cycler was sent to and received by the nxstage service and manufacturing site for evaluation. Testing showed that the ultrafiltration pump required calibration, after which the device passed all testing. When in critical care, the patient? S hemodynamic, fluid, and electrolyte balance must be monitored regularly, and their total fluid balance must account for weighing technique, scale accuracy, fluid consumption and output. Patients in critical care have multiple potential sources of fluid input as part of their care plan which impact their fluid balance status. The user guide states that all treatments must be administered under a physician? S prescription. A trained and qualified person must observe all treatments to monitor vital signs in response to therapy, their general well-being and physical status, and to promptly respond to harmful conditions that may occur. Udi #: (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[188244156] A report was received on 06 nov 2019 from a biomedical engineer regarding an adult patient in critical care for pulmonary edema, pericardial effusion, and generalized edema who experienced worsened generalized edema and weight increase during continuous veno-venous hemofiltration (cvvh) treatments using the nxstage system on an unspecified date. Additional information was received on 24 feb 2020 from the nurse stating the patient was not responding as expected and had worsened generalized edema after treating on the nxstage device for multiple unspecified days. Despite requests, no information regarding related medical intervention was provided. Fluid balance details during this time, outlining the patient? S intake and output, including medically administered fluids, were not provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3003464075-2020-00016
MDR Report Key9847883
Report SourceHEALTH PROFESSIONAL
Date Received2020-03-18
Date of Report2020-03-18
Report Date2005-01-01
Date Reported to FDA2005-01-01
Date Reported to Mfgr2005-01-10
Date Mfgr Received2020-02-19
Date Added to Maude2020-03-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationBIOMEDICAL ENGINEER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. PAULA ROGALSKI
Manufacturer StreetNXSTAGE MEDICAL, INC 350 MERRIMACK STREET
Manufacturer CityLAWRENCE MA 01843
Manufacturer CountryUS
Manufacturer Postal01843
Manufacturer Phone9784505276
Manufacturer G1MEDIMEXICO S. DE R. L. DE C. V
Manufacturer StreetAV. VALLE IMPERIAL NO. 10523 PARQUE INDUSTRIAL VALLE SUR
Manufacturer CityTIJUANA 22180
Manufacturer CountryMX
Manufacturer Postal Code22180
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameNXSTAGE SYSTEM ONE
Generic NameHIGH PERMEABILITY HEMODIALYSIS SYSTEM
Product CodeKDI
Date Received2020-03-18
Returned To Mfg2020-01-29
Model NumberNX1000-5
Catalog NumberACUTE CYCLER 3RD ED W/ ONEVIEW
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Sequence No1
Device Event Key0
ManufacturerNXSTAGE MEDICAL, INC.
Manufacturer Address350 MERRIMACK STREET LAWRENCE MA 01843 US 01843

Device Sequence Number: 101

Brand NameACETAMINOPHEN 500MG
Product Code---
Date Received2020-03-18
Device Sequence No101
Device Event Key0
ManufacturerMANUFACTURE / COMPOUNDER NAME


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-03-18

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