FDA Adverse Event Malfunction Summary report: N

INTERLINK CATHETER EXTENSION SET/MALE LUER

MDR report key: 1240246 · Received November 24, 2008

Report

Report Number
6000001-2007-05634
Event Type
Malfunction
Date Received
November 24, 2008
Date of Event
April 2, 2007
Report Date
April 11, 2007
Manufacturer
BAXTER HEALTHCARE
Product Code
FPA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

RETURN OF THE ACTUAL DEVICE FOR EVALUATION WAS REQUESTED. SHOULD THE SAMPLE BECOME AVAILABLE FOR EVALUATION, A FOLLOW-UP REPORT WILL BE SUBMITTED UPON COMPLETION OF TESTING. THE MANUFACTURING FACILITY HAS BEEN MADE AWARE OF THIS REPORT THROUGH BAXTER'S COMPLAINT MANAGEMENT TRACKING SYSTEM. THE MANUFACTURING FACILITY WILL CONTINUE TO MONITOR SIMILAR REPORTS FOR POSSIBLE TRENDS.

Description of Event or Problem · 1

INTERNATIONAL COMPLAINT RECEIVED. CUSTOMER REPORTS LEAK OF MULTIPLE VITAMIN DURING PATIENT USE. NO PATIENT INJURY OR MEDICAL INTERVENTION. NO ADDITIONAL INFORMATION WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTERLINK CATHETER EXTENSION SET/MALE LUER INTERLINK EXTENSION SETS FPA BAXTER HEALTHCARE NA NA 01

Patients

Seq Age Sex Outcome Treatment
1 MULTIPLE VITAMIN.