FDA Adverse Event Injury Summary report: N

LONG SELF-CATH CH14

MDR report key: 2370081 · Received May 6, 2010

Report

Report Number
2183558-2010-00018
Event Type
Injury
Date Received
May 6, 2010
Date of Event
January 1, 2008
Report Date
January 15, 2008
Manufacturer
COLOPLAST MANUFACTURING US, LLC
Product Code
KOD
PMA / PMN Number
K003784
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT WAS NOT AVAILABLE TO BE RETURNED. WITHOUT THE BENEFIT OF EXAMINATION AND TESTING, COLOPLAST IS PRECLUDED FROM COMMENTING ON THE CONDITION OF THE DEVICE OR THE CAUSE OF THE OCCURRENCE. SHOULD THE DEVICE OR ADDITIONAL INFORMATION BE RECEIVED, A FOLLOW UP REPORT WILL BE FILED.

Description of Event or Problem · 1

ACCORDING TO THE INFORMATION RECEIVED, AN END USER REPORTED A CATHETER WITH NO EYELETS WHICH WOULD NOT LET URINE FLOW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LONG SELF-CATH CH14 INTERMITTENT CATHETER, PRODUCT CODE: KOD KOD COLOPLAST MANUFACTURING US, LLC 5022101400 5719454

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention