FDA Adverse Event Malfunction Summary report: N

BIOFLEX TESIO CATH

MDR report key: 1022049 · Received March 28, 2008

Report

Report Number
2518902-2008-00010
Event Type
Malfunction
Date Received
March 28, 2008
Date of Event
January 8, 2008
Report Date
March 26, 2008
Manufacturer
MEDCOMP
Product Code
MSD
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN INVESTIGATION HAS BEEN INITIATED. A REVIEW OF THE MANUFACTURING RECORDS INDICATED THAT ALL DEVICE SPECIFICATIONS AND QUALITY REQUIREMENTS WERE SATISFIED. THE DEVICE SAMPLE WAS FORWARDED TO THE MFR FOR EVAL. WHEN THE INVESTIGATION IS COMPLETE, A FINAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THERE WAS A TEAR IN THE LUMEN SECTION THAT IS OVER THE METAL CANNULA AND UNDER THE COMPRESSION RING AND COLLAR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIOFLEX TESIO CATH HEMODIALYSIS CATHETER MSD MEDCOMP BFS-6-J MALA500

Patients

Seq Age Sex Outcome Treatment
1 79 YR Required Intervention