FDA Adverse Event Malfunction Summary report: N

RUSCH FOLEY CATHETER, 2-WAY/PED, 3CC, 8FR

MDR report key: 2142103 · Received May 26, 2011

Report

Report Number
8040412-2011-00081
Event Type
Malfunction
Date Received
May 26, 2011
Report Date
May 16, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
EZL
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHARMACIST

Narratives

Additional Manufacturer Narrative · 1

NO SAMPLE IS AVAILABLE FOR THE MFR TO EVALUATE. A F/U REPORT WILL BE SENT WHEN INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: PER FRANCE AFFILIATE: THE CATHETER SPLIT IN TWO WHEN SLIDING THE NAPPY UNDER THE BABY EVEN IF THERE WAS A SECURITY BUCKLE AND NO FORCE WAS APPLIED. ANOTHER CATHETER WAS SUCCESSFULLY USED. PT CURRENT CONDITION IS FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RUSCH FOLEY CATHETER, 2-WAY/PED, 3CC, 8FR FOLEY CATHETER EZL TELEFLEX MEDICAL NA 11AE05

Patients

Seq Age Sex Outcome Treatment
1 UNK