FDA Adverse Event Malfunction Summary report: N

CURLIN ADMINISTRATION SET

MDR report key: 2061376 · Received March 18, 2011

Report

Report Number
1722139-2011-00034
Event Type
Malfunction
Date Received
March 18, 2011
Date of Event
February 14, 2011
Report Date
March 18, 2011
Manufacturer
MOOG MEDICAL DEVICES GROUP
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION PROVIDED IN THE COMPLAINT WAS UNCLEAR SO THE CUSTOMER E-MAIL (NO NUMBER PROVIDED) TO ASK FOR CLARIFICATION. THE COMPLAINT, AS REPORTED, APPEARS AS THOUGH THE PINCH CLAMP OCCLUDER BREAK AWAY TAB WAS NOT REMOVED. THE TAB, WHEN REMOVED, ALLOWS THE PINCH CLAMP TO ENGAGE OCCLUDING THE TUBING. DIRECTIONS FOR USE ARE TO REMOVE THE BREAKAWAY TAB BEFORE PRIMING. A FOLLOW UP WILL BE SUBMITTED WHEN A RESPONSE FROM THE NURSE IS RECEIVED.

Description of Event or Problem · 1

COMPLAINT STATES THAT THE SET LEAKED. LIQUID HAS GONE STRAIGHT THROUGH AS THOUGH NOT CLAMPED. DURING PRIMING LIQUID WENT THROUGH IN MINUTES NOT SECONDS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CURLIN ADMINISTRATION SET FRN MOOG MEDICAL DEVICES GROUP 340-4163 D934103

Patients

Seq Age Sex Outcome Treatment
1