FDA Adverse Event Malfunction Summary report: N

HT APPLIER MED 6' CVD

MDR report key: 2900884 · Received December 12, 2012

Report

Report Number
1044475-2012-00164
Event Type
Malfunction
Date Received
December 12, 2012
Date of Event
November 29, 2012
Report Date
November 29, 2012
Manufacturer
TELEFLEX
Product Code
FZP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE SAMPLE WAS NOT RECEIVED BY THE MFR AT THE TIME OF THIS REPORT.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: ALLEGED ISSUE: DURING INCOMING INSPECTION OF DEVICE, THE DOCTOR SAID ON A VIDEO HE PROVIDED THAT WHEN THE APPLIER CLOSES THE CLIP, THE ENDS DON'T MEET PROPERLY. NO PT CONSEQUENCES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HT APPLIER MED 6' CVD APPLIER FZP TELEFLEX 06B1141116

Patients

Seq Age Sex Outcome Treatment
1