FDA Adverse Event Malfunction Summary report: N

GEMSTR 7 THPY ALT ST

MDR report key: 2941278 · Received January 31, 2013

Report

Report Number
9615050-2013-00151
Event Type
Malfunction
Date Received
January 31, 2013
Date of Event
December 1, 2012
Report Date
January 4, 2013
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K060806
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED. INVESTIGATION IS NOT COMPLETE. THIS REPORT REPRESENTS ALL THE INFORMATION KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THE DEVICE DID NOT DELIVER. NO SPECIFIC EVENT DETAILS WERE PROVIDED. THERE WERE NO REPORTS OF ANY ADVERSE PATIENT EVENTS WHILE THE DEVICE WAS IN CLINICAL USE. MULTIPLE UNSUCCESSFUL ATTEMPTS HAVE BEEN MADE TO OBTAIN ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
43463 GEMSTR 7 THPY ALT ST 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA