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