FDA Adverse Event Malfunction Summary report: N

DURAMAX CHRONIC HEMODIALYSIS CATHETER

MDR report key: 2010246 · Received February 11, 2011

Report

Report Number
1319211-2011-00012
Event Type
Malfunction
Date Received
February 11, 2011
Date of Event
January 12, 2011
Report Date
February 11, 2011
Manufacturer
ANGIODYNAMICS
Product Code
MSD
PMA / PMN Number
K080400
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

ALTHOUGH THE REPORTED DEFECTIVE DEVICE WAS DISPOSED OFF BY THE END USER, AN INVESTIGATION INTO THE ROOT CAUSE FOR THIS INCIDENT IS CURRENTLY IN PROGRESS. THE RESULTS OF THE INVESTIGATION WILL BE SENT VIA A FOLLOW UP MEDWATCH.

Description of Event or Problem · 1

AS REPORTED ON (B)(6) 2011 BY THE END USER, WHILE TUNNELING A DIALYSIS CATHETER, THE TUNNELER SLEEVE CRACKED. THERE WAS NO HARM TO THE PATIENT AND NO FURTHER MEDICAL INTERVENTION WAS REQUIRED. THE PROCEDURE WAS SUCCESSFULLY COMPLETED WITH THIS DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DURAMAX CHRONIC HEMODIALYSIS CATHETER DIALYSIS CATHETER MSD ANGIODYNAMICS NA C28714

Patients

Seq Age Sex Outcome Treatment
1