FDA Adverse Event Malfunction Summary report: N

TRANSTAR PATIENT MOUNT MONITORING KIT

MDR report key: 1181942 · Received September 26, 2008

Report

Report Number
9616567-2008-00079
Event Type
Malfunction
Date Received
September 26, 2008
Date of Event
August 27, 2008
Report Date
August 27, 2008
Manufacturer
SMITHS MEDICAL, ASD.
Product Code
DRS
PMA / PMN Number
K942377
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SAMPLES HAVE BEEN RECEIVED FROM THE CUSTOMER; HOWEVER, SMITHS HAS NOT YET COMPLETED ITS INVESTIGATION. A FOLLOW UP MDR WILL BE SUBMITTED WHEN THE INVESTIGATION HAS BEEN COMPLETED.

Description of Event or Problem · 1

A HEALTH CENTER REPORTED TO SMITHS MEDICAL THAT THE EQUIPMENT CAME APART AT THE LUER LOCK DESPITE HAVING SECURELY FASTENED IT EARLIER IN THE SHIFT. THERE WAS NO PT INJURY OR TREATMENT REPORTED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRANSTAR PATIENT MOUNT MONITORING KIT PRESSURE MONITORING SET DRS SMITHS MEDICAL, ASD. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK