FDA Adverse Event Other Summary report: N

CIRCLE C SILICONE CATHETER KIT

MDR report key: 246155 · Received October 26, 1999

Report

Report Number
1056436-1999-00184
Event Type
Other
Date Received
October 26, 1999
Date of Event
October 5, 1999
Report Date
October 7, 1999
Manufacturer
NEOSTAR MEDICAL TECHNOLOGIES/HORIZON MEDICAL PRODUCTS, INC
Product Code
FJS
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

ON 10/07/1999, THE DISTRIBUTOR'S SALES REP INFORMED THE MFR THAT A CUSTOMER IN HIS TERRITORY EXPERIENCED TWO (2) PROBLEMS (REF MDR# 1056436-1999-183 FOR FIRST PROBLEM) WITH THIS PRODUCT; HOWEVER, HE DID NOT HAVE ALL THE INFO AVAILABLE. ON 10/11/1999, THE MFR RECEIVED A FAXED REPORT FROM THE DISTRIBUTOR'S SALES REP THAT STATES THE FOLLOWING: PER THE FACILITY'S CLINICAL NURSE SPECIALIST, HOLES IN CATHETER EXTENSIONS. PT'S WHO ARE RECEIVING REPLACEMENT CATHETERS. SOME ARE SHOWING UP WITH PINHOLES IN EXTENSIONS. ADD'L INFO STATES THAT THE CATHETER WAS PLACED OVER GUIDEWIRE 10/01/1999. HOLES NOTED 10/05/1999 AT DIALYSIS. NO FURTHER DETAILS WERE PROVIDED AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CIRCLE C SILICONE CATHETER KIT Implant CHRONIC SILICONE CATHETER FJS NEOSTAR MEDICAL TECHNOLOGIES/HORIZON MEDICAL PRODUCTS, INC NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other