FDA Adverse Event Malfunction Summary report: N

RUSCH 100 PERCENT SILICONE FOLEY CATHETER, 14FR

MDR report key: 1931932 · Received November 29, 2010

Report

Report Number
8040412-2010-00100
Event Type
Malfunction
Date Received
November 29, 2010
Report Date
November 3, 2010
Manufacturer
TELEFLEX MEDICAL
Product Code
KOD
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE SAMPLE WILL BE SENT BY THE FRENCH AFFILIATE TO THE MFG FACILITY FOR EVAL. THE RESULTS OF THE INVESTIGATION ARE NOT AVAILABLE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: A SMALL HERNIA REMAINS AT THE DISTAL END OF THE BALLOON AFTER IT IS DEFLATED. THERE WAS SOME PAIN FOR THE PT DURING WITHDRAWAL OF THE CATHETER. NO PT INJURY OR INTERVENTION REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RUSCH 100 PERCENT SILICONE FOLEY CATHETER, 14FR UROLOGICAL FOLEY CATHETER KOD TELEFLEX MEDICAL NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK