FDA Adverse Event Malfunction Summary report: N

INTERLINK I.V. CONN LOOP/MALE LUER SLIP ADAPTER

MDR report key: 1240290 · Received November 24, 2008

Report

Report Number
6000001-2007-01748
Event Type
Malfunction
Date Received
November 24, 2008
Date of Event
January 1, 2007
Report Date
January 16, 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 ANOTHER COUNTRY'S CO WAS LISTED AS LOT NUMBER S06G06105R. THIS CODE IS MANUFACTURED IN ANOTHER COUNTRY, AND ONLY DISTRIBUTED IN OTHER COUNTRY. THIS MEDWATCH WAS FILED FOR THE US, WHICH IS THE SAME AS OR SIMILAR.

Description of Event or Problem · 1

INTERNATIONAL COMPLAINT RECEIVED. CUSTOMER REPORTS ¿LEAK/TUBING-FEMALE CONNECTOR¿ DURING PRIMING. 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 I.V. CONN LOOP/MALE LUER SLIP ADAPTER INTERLINK EXTENSION SETS FPA BAXTER HEALTHCARE CORPORATION NA NA01

Patients

Seq Age Sex Outcome Treatment
1