FDA Adverse Event Malfunction Summary report: N

VISTA BRITE TIP GUIDING CATHETERS

MDR report key: 1052029 · Received May 20, 2008

Report

Report Number
9616099-2008-01359
Event Type
Malfunction
Date Received
May 20, 2008
Date of Event
April 20, 2008
Report Date
April 25, 2008
Manufacturer
CORDIS DE MEXICO
Product Code
DQY
PMA / PMN Number
K021593
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE REPORT RECEIVED FROM THE ACCOUNT INDICATED THAT THE GUIDING CATHETER BROKE APPROXIMATELY 3 INCHES FROM THE DISTAL END WHILE BEING REMOVED FROM ITS STERILE PACKAGING. THE BROKEN SEGMENT SEPARATED TOTALLY FROM THE REST OF THE GUIDE. THE PRODUCT WAS NEVER USED CLINICALLY. THE PRODUCT IS AVAILABLE FOR EVAL AND TESTING; HOWEVER, IT HAS NOT BEEN RECEIVED TO DATE. ADDITIONAL INFO WILL BE SUBMITTED WITHIN 30 DAYS OF RECEIPT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VISTA BRITE TIP GUIDING CATHETERS CARDIOLOGY GUIDING CATHETERS (DQY) DQY CORDIS DE MEXICO NA UNK

Patients

Seq Age Sex Outcome Treatment
1 NA