FDA Adverse Event Malfunction Summary report: N

TRANSTAR 84 IN SINGLE MONITORING KIT

MDR report key: 1882481 · Received October 21, 2010

Report

Report Number
2183502-2010-00465
Event Type
Malfunction
Date Received
October 21, 2010
Date of Event
September 21, 2010
Report Date
October 19, 2010
Manufacturer
SMITHS MEDICAL ASD, INC.
Product Code
DPT
PMA / PMN Number
K942377
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). CUSTOMER HAS NOT YET RETURNED THE DEVICE TO THE MANUFACTURER FOR DEVICE EVALUATION. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED, THE MANUFACTURER WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION.

Description of Event or Problem · 1

THE REPORTER STATED THAT THE DEVICE LEAKED FROM THE STOPCOCK DURING USE. THERE WAS NO REPORTED PATIENT INJURY OR TREATMENT ASSOCIATED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRANSTAR 84 IN SINGLE MONITORING KIT PRESSURE MONITORING SET DPT SMITHS MEDICAL ASD, INC. NA 1549351

Patients

Seq Age Sex Outcome Treatment
1 UNK