FDA Adverse Event Malfunction Summary report: N

BASHIR ENDOVASCULAR CATHETER PLUS40

MDR report key: 16689146 · Received April 5, 2023

Report

Report Number
MW5116371
Event Type
Malfunction
Date Received
April 5, 2023
Date of Event
February 10, 2021
Report Date
March 29, 2023
Manufacturer
THROMBOLEX, INC.
Product Code
KRA
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
PA, US
Reporter Occupation
003
Health Professional
N

Narratives

Description of Event or Problem · 0

BLEEDING OCCURRED WHEN WIRE LUMEN PORT BROKE WHILE PATIENT WAS BEING INFUSED. REF REPORT: MW5116370.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
518791 BASHIR ENDOVASCULAR CATHETER PLUS40 CATHETER, CONTINUOUS FLUSH KRA THROMBOLEX, INC. UNK

Patients

Seq Age Sex Outcome Treatment
1 40 YR Male Other