FDA Adverse Event Malfunction Summary report: N

RUSCH FOLEY CATHETERS, 2-WAY PEDIATRIC, 8FR

MDR report key: 2142125 · Received May 26, 2011

Report

Report Number
8040412-2011-00078
Event Type
Malfunction
Date Received
May 26, 2011
Date of Event
February 23, 2011
Report Date
May 6, 2011
Manufacturer
TELEFLEX MEDICAL
Product Code
KOD
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

NO SAMPLE IS AVAILABLE FOR THE MANUFACTURER TO EVALUATE. A FOLLOW-UP REPORT WILL BE SENT WHEN INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: COMPLAINT ALLEGED: AFTER THE CATHETER INSERTION, THE STYLET BROKE DURING THE REMOVAL. THE CATHETER WAS REMOVED AND A NEW ONE WAS SUCCESSFULLY INSERTED. NO PART REMAINED INSIDE THE PATIENT. THE PATIENT CURRENT CONDITION IS FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RUSCH FOLEY CATHETERS, 2-WAY PEDIATRIC, 8FR FOLEY CATHETER KOD TELEFLEX MEDICAL NA 10DE14

Patients

Seq Age Sex Outcome Treatment
1 UNK