STELLANT DUAL CT INJECTOR 58746456 SCT D

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 2020-03-18 for STELLANT DUAL CT INJECTOR 58746456 SCT D manufactured by Bayer Medical Care Inc..

Event Text Entries

[188649687] A system service check of the stellant ct injector, serial number (b)(4), was completed on march 10, 2020 which confirmed that the injector was operating within bayer specifications. There was no evidence of equipment malfunction. Multiple documented attempts have been made to gain specific information related to the reported event; however, these attempts have been unsuccessful. The offer of additional clinical applications training has been made to the customer and we are awaiting their response. The site continues to use the stellant ct injection system after the reported event with no further issues reported. In the event that additional information is obtained, a follow-up report will be submitted.
Patient Sequence No: 1, Text Type: N, H10


[188649688] On march 9, 2020, bayer medical care received information that a patient who was undergoing a ct scan suffered an alleged air injection while connected to a stellant ct injection system. The patient was reported to have required medical treatment for the air injection; however, no details were provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2520313-2020-00011
MDR Report Key9848462
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-18
Date of Report2020-03-18
Date of Event2020-03-09
Date Mfgr Received2020-03-09
Device Manufacturer Date2013-09-26
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 ContactDIANE ECKERT
Manufacturer Street1 BAYER DRIVE
Manufacturer CityINDIANOLA PA 15051
Manufacturer CountryUS
Manufacturer Postal15051
Manufacturer Phone7249408677
Manufacturer G1BAYER MEDICAL CARE INC.
Manufacturer Street1 BAYER DRIVE
Manufacturer CityINDIANOLA PA 15051
Manufacturer CountryUS
Manufacturer Postal Code15051
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSTELLANT DUAL CT INJECTOR
Generic NameCT INJECTION SYSTEM
Product CodeDXT
Date Received2020-03-18
Model Number58746456
Catalog NumberSCT D
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerBAYER MEDICAL CARE INC.
Manufacturer Address1 BAYER DRIVE INDIANOLA PA 15051 US 15051


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-03-18

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