FDA Adverse Event Malfunction Summary report: N

RUSCH FOLEY CATHETERS, 2-WAY PEDIATRIC, 6FR

MDR report key: 2110009 · Received May 16, 2011

Report

Report Number
8040412-2011-00070
Event Type
Malfunction
Date Received
May 16, 2011
Date of Event
February 1, 2011
Report Date
April 28, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
KOD
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE SAMPLE WAS NOT RECEIVED BY THE MFR AT THE TIME OF THIS REPORT. A F/U REPORT WILL BE SENT WHEN COMPLETION OF INVESTIGATION.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: COMPLAINT ALLEGES THAT THE CATHETER SNAPPED MIDWAY DOWN THE CATHETER WITHOUT DECOMPRESSING THE BALLOON AND HAD TO BE REMOVED WITH FORCEPS. THERE WAS NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RUSCH FOLEY CATHETERS, 2-WAY PEDIATRIC, 6FR FOLEY CATHETER KOD TELEFLEX MEDICAL NA 10DE14

Patients

Seq Age Sex Outcome Treatment
1 UNK