FDA Adverse Event
Injury
Summary report: N
BD SURGIPHOR¿ STERILE WOUND IRRIGATION SYSTEM
MDR report key: 16153361
·
Received January 12, 2023
Report
- Report Number
- 1423507-2023-00035
- Event Type
- Injury
- Date Received
- January 12, 2023
- Date of Event
- December 19, 2022
- Report Date
- January 12, 2023
- Manufacturer
- CAREFUSION, INC
- Product Code
- FQH
- PMA / PMN Number
- K202071
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
Additional Manufacturer Narrative · 0
PR (B)(4). MDR. BD WAS UNABLE TO PERFORM A THOROUGH INVESTIGATION AS NO SAMPLE, LOT OR BATCH NUMBER WERE PROVIDED. A FOLLOW-UP WILL BE PROVIDED IF ADDITIONAL INFORMATION IS RECEIVED. 2B PROCODE: FQH (LAVAGE, JET) AND FRO (DRESSING, WOUND, DRUG).
Description of Event or Problem · 0
IT WAS REPORTED THAT THERE WAS A FOREIGN PARTICLE THAT REQUIRED MEDICAL INTERVENTION (MEDICATION).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2017763 | BD SURGIPHOR¿ STERILE WOUND IRRIGATION SYSTEM | SURGIPHOR | FQH | CAREFUSION, INC | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown | Required Intervention |