FDA Adverse Event Other Summary report: N

FAST1 INTRAOSSEOUS INFUSION SYSTEM

MDR report key: 1422973 · Received July 20, 2009

Report

Report Number
9615387-2009-00033
Event Type
Other
Date Received
July 20, 2009
Date of Event
June 1, 2009
Report Date
July 16, 2009
Manufacturer
PYNG MEDICAL CORP.
Product Code
FMI
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AU
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS PRODUCT DOES NOT HAVE A 510(K) NUMBER. THE PRODUCT HAS (B)(4) AND A (B)(4). AN ANALOGOUS PRODUCT SOLD IN THE US HAS 510(K) NUMBER K080865. STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

INSERTION DIFFICULTY. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FAST1 INTRAOSSEOUS INFUSION SYSTEM FMI PYNG MEDICAL CORP. 01-0017-001

Patients

Seq Age Sex Outcome Treatment
1 82 YR Other