FDA Adverse Event Malfunction Summary report: N

ACCESS

MDR report key: 3130507 · Received May 24, 2013

Report

Report Number
1416980-2013-13404
Event Type
Malfunction
Date Received
May 24, 2013
Date of Event
February 22, 2013
Report Date
May 2, 2013
Manufacturer
BAXTER HEALTHCARE
Product Code
FPA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). A BATCH REVIEW WAS CONDUCTED AND THERE WERE NO DEVIATIONS FOUND RELATED TO THIS REPORTED CONDITION DURING THE MANUFACTURE OF THIS LOT. THE SAMPLE WAS VISUALLY INSPECTED AND NO NONCONFORMANCES WERE OBSERVED. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CYSTO/BLADDER IRRIGATION SET PACKAGING RIPPED WHEN OPENING, COMPROMISING THE STERILITY OF THE PRODUCT. THIS WAS NOTICED BEFORE USE. ADDITIONAL INFORMATION WAS REQUESTED AND IS NOT AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
232270 ACCESS SET, ADMINISTRATION, INTRAVASCULAR FPA BAXTER HEALTHCARE R12K08189

Patients

Seq Age Sex Outcome Treatment
1