FDA Adverse Event Malfunction Summary report: N

SAFETOUCH II

MDR report key: 1334864 · Received October 21, 2008

Report

Report Number
1056186-2008-00004
Event Type
Malfunction
Date Received
October 21, 2008
Date of Event
August 12, 2008
Report Date
September 22, 2008
Manufacturer
NIPRO MEDICAL CORPORATION
Product Code
FMI
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NIPRO RENAL SPECIALIST SPOKE WITH INITIAL REPORTER ON 9/24/2008. SHE STATED THE ROOT CAUSE OF THE PROBLEM WAS RELATED TO THE USE OF ETHYL CHLORIDE SPRAY USED ON PATIENTS PRIOR TO CANNULATION. EVALUATION IS ONGOING AT MANUFACTURING FACILITY.

Description of Event or Problem · 1

ON 09/22/2008, NIPRO MEDICAL RECEIVED REPORT FROM FDA REGARDING AN INCIDENT WITH THE SAFETOUCH II SAFETY AVF NEEDLE. REPORT STATES THAT AFTER THE DIALYSIS TREATMENT WAS FINISHED, STAFF COULD NOT ACTIVATE SAFETY MECHANISM ON NEEDLE. NO INJURY TO PT OR STAFF WAS NOTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SAFETOUCH II SAFETY AVF NEEDLE FMI NIPRO MEDICAL CORPORATION 15G X 1" HC-30W 07F21

Patients

Seq Age Sex Outcome Treatment
1 NA