FDA Adverse Event Malfunction Summary report: N

INTERLINK CATHETER EXTENSION SET

MDR report key: 1240253 · Received November 24, 2008

Report

Report Number
6000001-2007-05691
Event Type
Malfunction
Date Received
November 24, 2008
Date of Event
March 11, 2007
Report Date
March 19, 2007
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FPA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A REQUEST FOR THE RETURN OF THE DEVICE HAS BEEN MADE, SHOULD THE REPORTED DEVICE BE RETURNED AND EVALUATED A FOLLOW UP REPORT WILL BE SUBMITTED. THE CODE REPORTED BY BAXTER WAS LISTED LOT NUMBER S06H18082R. THIS CODE IS MANUFACTURED AND ONLY DISTRIBUTED IN ANOTHER COUNTRY. THIS MEDWATCH WAS FILED FOR THE US CODE, WHICH IS THE SAME AS OR SIMILAR.

Description of Event or Problem · 1

BAXTER REPORTED A COMPLAINT FOR OFF/TUBING-MALE CONNECTOR DURING PATIENT USE. THERE WAS NO REPORTED PATIENT INJURY OR MEDICAL INTERVENTION. NO ADDITIONAL INFORMATION IS AVAILABLE

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTERLINK CATHETER EXTENSION SET INTERLINK EXTENSION SETS FPA BAXTER HEALTHCARE CORPORATION NA NA01

Patients

Seq Age Sex Outcome Treatment
1