FDA Adverse Event Malfunction Summary report: N

HUDSON ISO-GARD DEPTH FILTER

MDR report key: 3032753 · Received March 29, 2013

Report

Report Number
8040412-2013-00062
Event Type
Malfunction
Date Received
March 29, 2013
Date of Event
March 1, 2013
Report Date
March 18, 2013
Manufacturer
TELEFLEX MEDICAL
Product Code
CAH
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE SAMPLE WAS RECEIVED FOR EVALUATION, BUT THE INVESTIGATION IS INCOMPLETE AT THE TIME OF THIS REPORT.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: THE CUSTOMER ALLEGES THAT THE HME FILTER BROKE DURING USE ON A PATIENT. THE CLINICIAN PUT A NEW HME ON THE PATIENT. NO REPORT OF PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
130439 HUDSON ISO-GARD DEPTH FILTER HME FILTER CAH TELEFLEX MEDICAL

Patients

Seq Age Sex Outcome Treatment
1