FDA Adverse Event
Malfunction
Summary report: N
ONGUARD2
MDR report key: 15549370
·
Received October 6, 2022
Report
- Report Number
- 9611423-2022-00036
- Event Type
- Malfunction
- Date Received
- October 6, 2022
- Date of Event
- May 12, 2022
- Report Date
- October 6, 2022
- Manufacturer
- SIMPLIVIA HEALTHCARE LTD.
- Product Code
- ONB
- UDI-DI
- 37290115921435
- PMA / PMN Number
- K192866
- Removal / Correction Number
- Z-1057-2022
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- PHARMACIST
- Health Professional
- Yes
Narratives
Description of Event or Problem · 0
A PRODUCT COMPLAINT HAS BEEN ISSUE FOR THE DEFECTIVE ITEM. ITEM 412143 7 CS. DESCRIPTION: ITEM LEAKING. CUSTOMER OPEN 1CS AND USED THE 1BX ( 2BX/CS ) BUT 1BX WAS LEAKING. THEY STOPPED USING THE ENTIRE ORDER ( 7CS ).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2151087 | ONGUARD2 | ONGUARD2 BAG ADAPTOR SP | ONB | SIMPLIVIA HEALTHCARE LTD. | 37290115921435 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |