FDA Adverse Event
Malfunction
Summary report: N
FASTLOAD CTA DUAL SYRINGE PACK
MDR report key: 20075009
·
Received August 27, 2024
Report
- Report Number
- 20075009
- Event Type
- Malfunction
- Date Received
- August 27, 2024
- Date of Event
- August 13, 2024
- Report Date
- August 23, 2024
- Manufacturer
- BRACCO INJENEERING S.A.
- Product Code
- DXT
- UDI-DI
- 17630039300880
- Product Problem
- Yes
- Report Source
- User Facility report
- Reporter Location
- OH
- Reporter Occupation
- RISK MANAGER
- Health Professional
- N
Narratives
Description of Event or Problem · 0
PROCEDURE: CT, NEW BRACCO- FASTLOAD CTA DUAL SYRINGE PACK OPENED- MISSING STRAW AND TUBING. NOT USED ON PATIENT. MANUFACTURER RESPONSE FOR INJECTOR AND SYRINGE, ANGIOGRAPHIC, FASTLOAD CTA DUAL SYRINGE PACK (PER SITE REPORTER), WILL OBTAIN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 969256 | FASTLOAD CTA DUAL SYRINGE PACK | INJECTOR AND SYRINGE, ANGIOGRAPHIC | DXT | BRACCO INJENEERING S.A. | 017354 | 256819 | 17630039300880 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Prefer Not To Disclose |