FDA Adverse Event Other Summary report: N

CURLIN ADMINISTRATION SET

MDR report key: 1640187 · Received March 19, 2010

Report

Report Number
1722139-2010-00024
Event Type
Other
Date Received
March 19, 2010
Date of Event
January 4, 2010
Report Date
March 1, 2010
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
FPA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THIS IS A FOLLOW UP REPORT TO ORIGINAL MDR 2031921-2008-0056. THIS REPORT WAS ORIGINALLY FILED UNDER THE ESTABLISHMENT REGISTRATION (B)(4). THIS FACILITY HAS BEEN CLOSED AND THE PRODUCTS ARE MANUFACTURED BY MOOG MEDICAL (B)(4). THE DEVICE WAS EVALUATED AND THE COMPLAINT WAS CONFIRMED TO LEAK. A SUPPLIER CORRECTIVE ACTION WAS ISSUED TO THE MANUFACTURER. THE MANUFACTURER STATED THAT THERE APPEARED TO BE AN INSUFFICIENT AMOUNT OF SOLVENT USED. CORRECTIVE AND PREVENTATIVE ACTIONS WERE IMPLEMENTED TO MITIGATE FUTURE OCCURRENCES.

Description of Event or Problem · 1

EVENT AS REPORTED: LEAKING AT TUBING CONNECTION ON THE DISTAL TO PUMPING SECTION, WHERE THE GOLD SET CONNECTOR CONNECTS TO THE IV ON THE PT. NO PT INJURY OCCURRED AS A RESULT OF THIS COMPLAINT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CURLIN ADMINISTRATION SET FPA MOOG MEDICAL DEVICES GROUP 340-4128 D70913

Patients

Seq Age Sex Outcome Treatment
1