FDA Adverse Event Injury Summary report: N

TYSHAK DILATATION CATHETER

MDR report key: 287430 · Received July 27, 2000

Report

Report Number
1318694-2000-00001
Event Type
Injury
Date Received
July 27, 2000
Date of Event
August 31, 1998
Report Date
July 27, 2000
Manufacturer
NUMED, INC.
Product Code
LIT
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

THE PERCUTANEOUS CORONARY ANGIOPLASTY BALLOON BURST AT UN UNSPECIFIED PRESSURE DURING AN UNSPECIFIED PROCEDURE. THE DR EXPERIENCED DIFFICULTY IN REMOVING THE CATHETER, WHICH WAS NOT DESCRIBED. NUMED CONTACTED THE DISTRIBUTOR WHO REPORTED THE ADVERSE EVENT. THE CO WAS NOT ABLE TO OBTAIN ANY ADDITIONAL INFO ABOUT THE ADVERSE EVENT, INCLUDING ANY INFO ABOUT THE OUTCOME OF THE PT'S CONDITION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TYSHAK DILATATION CATHETER PTA CATHETER LIT NUMED, INC. 102 T-1117

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other