FDA Adverse Event Other Summary report: N

V-CATH INTRODUCER

MDR report key: 2189690 · Received July 25, 2011

Report

Report Number
2925153-2011-00009
Event Type
Other
Date Received
July 25, 2011
Date of Event
April 8, 2011
Report Date
July 18, 2011
Manufacturer
NEO MED INC
Product Code
DYB
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

WILL PROVIDE F/U WHEN "DEVICE EVAL SUMMARY" IS COMPLETED. (B)(4).

Description of Event or Problem · 1

PRODUCT WAS SOLD TO THIRD PARTY (B)(4) THROUGH (B)(4) WAS NOTIFIED THAT THERE WAS A REPORT MADE BY END USER TO (B)(4)'S SALES REP WHO IN TURN CALLED (B)(4) REGARDING "DULL NEEDLES". (B)(4)'S COMPLAINT COORD NOTIFIED (B)(4) AND THIRD PARTY (B)(4) WITH RMA#. (B)(4) REQUESTED THE COMPLAINT TO BE PLACED ON HOLD UNTIL MORE INFO COULD BE OBTAINED FROM OWENS AND MINOR. ON (B)(6) 2011, NEO MEDICAL RECEIVED THE REQUEST TO RETURN THE DULL NEEDLES AND PROCEED WITH THE COMPLAINT. PRODUCT WAS RECEIVED ON (B)(4) 2011 FOR EVAL THAT ALSO INCLUDED FROM THE END USER "COMPLAINT DATA COLLECTION REPORT" (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 V-CATH INTRODUCER BREAKAWAY NEEDLE DYB NEO MED INC 350-20 1144

Patients

Seq Age Sex Outcome Treatment
1