FDA Adverse Event Malfunction Summary report: N

5.0FR URETHANE UMB CATH

MDR report key: 1162297 · Received September 5, 2008

Report

Report Number
1317749-2008-00146
Event Type
Malfunction
Date Received
September 5, 2008
Date of Event
August 8, 2008
Report Date
August 12, 2008
Manufacturer
TYCO HEALTHCARE/KENDALL
Product Code
FOS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SUBMIT DATE: 09/03/2008. AN INVESTIGATION IS CURRENTLY UNDERWAY; UPON COMPLETION, THE RESULTS WILL BE FORWARDED.

Description of Event or Problem · 1

IT WAS REPORTED TO TYCO HEALTHCARE/KENDALL, THAT A CUSTOMER HAD A PROBLEM WITH A UMBILICAL CATHETER. THE CUSTOMER REPORTS UVC CATHETER WAS PLACED AND ON THE MORNING OF 2008, IT WAS DISCOVERED THAT THE CATHETER BROKE BENEATH THE HUB CAUSING IV SOLUTION TO LEAK INTO THE BED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 5.0FR URETHANE UMB CATH UMBILICAL CATHETER FOS TYCO HEALTHCARE/KENDALL 8888160341 183948

Patients

Seq Age Sex Outcome Treatment
1 UNK