FDA Adverse Event Malfunction Summary report: N

DIALYSIS IMPLANTED CATHETER

MDR report key: 1900355 · Received October 26, 2010

Report

Report Number
3006260740-2010-00302
Event Type
Malfunction
Date Received
October 26, 2010
Date of Event
May 20, 2010
Report Date
October 14, 2010
Manufacturer
C. R. BARD INC. (BASD)
Product Code
MSD
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FI
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RETURNED TO THE MFR FOR EVAL. A CHR REVIEW IS NOT POSSIBLE, AS NO MFG LOT NUMBER HAS BEEN PROVIDED BY THE COMPLAINANT.

Description of Event or Problem · 1

FACILITY REPORTS THEY HAVE HAD A NUMBER OF EVENTS OF BREAKAGE IN THE BIFURCATION OF BOTH HEMOGLIDE AND HEMOSTAR CATHETERS. THEY HAVE NOT SAVED ANY EXPLANTED CATHETERS. WE HAVE REQUESTED FOR MORE INFO AND ANY ADD'L INFO WILL BE ADDED LATER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DIALYSIS IMPLANTED CATHETER CATHETER, HEMODIALYSIS, IMPLANTED MSD C. R. BARD INC. (BASD) UNK

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention