FDA Adverse Event Injury Summary report: N

SAFESTEP 22GX3/4

MDR report key: 1292030 · Received January 16, 2009

Report

Report Number
3006260740-2009-00023
Event Type
Injury
Date Received
January 16, 2009
Date of Event
October 14, 2008
Report Date
December 22, 2008
Manufacturer
C.R. BARD INC. (BASD)
Product Code
FPA
PMA / PMN Number
K040527
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NO INFORMATION

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RETURNED TO THE MFR AT THIS TIME FOR EVALUATION. A CHR REVIEW SHOWED ONE OTHER SIMILAR PRODUCT COMPLAINT FILE(S) FROM THIS LOT. (202874).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PRODUCT LEAKED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SAFESTEP 22GX3/4 FPA C.R. BARD INC. (BASD) D817535

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention