FDA Adverse Event Malfunction Summary report: N

BEMIS 800CC HYDROPHOBIC SUCTION CANISTER

MDR report key: 1003717 · Received February 19, 2008

Report

Report Number
2133713-2008-00001
Event Type
Malfunction
Date Received
February 19, 2008
Date of Event
January 21, 2008
Report Date
February 18, 2008
Manufacturer
BEMIS MANUFACTURING
Product Code
KDQ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SAMPLES FROM THE SAME BATCH THAT HAD THE ALLEGED FAILURE WERE RETURNED BY REP FOR TESTING. FAILURE COULD NOT BE DUPLICATED.

Description of Event or Problem · 1

SALES REP WAS DEMONSTRATING 800CC SUCTION CANISTER WITH HYDROPHOBIC SHUTOFF. DURING DEMONSTRATION, THERE WAS A FLUID BACKUP. THERE WERE NO PATIENT CONSEQUENCES, AND NO EXPOSURE TO FLUID.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BEMIS 800CC HYDROPHOBIC SUCTION CANISTER BOTTLE, COLLECTION, VACUUM KDQ BEMIS MANUFACTURING 424410 UNK

Patients

Seq Age Sex Outcome Treatment
1