FDA Adverse Event Malfunction Summary report: N

SIL R ANG THORACIC 32FR

MDR report key: 3180179 · Received June 4, 2013

Report

Report Number
1282497-2013-00021
Event Type
Malfunction
Date Received
June 4, 2013
Date of Event
April 1, 2013
Report Date
May 7, 2013
Manufacturer
COVIDIEN
Product Code
KDQ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

SUBMIT DATE: (B)(4) 2013. AN INVESTIGATION IS CURRENTLY UNDERWAY. UPON COMPLETION, THE RESULTS WILL BE FORWARDED.

Description of Event or Problem · 1

IT WAS REPORTED TO COVIDIEN ON (B)(6) 2013 THAT A CUSTOMER HAD AN ISSUE WITH A THORACIC CATHETER. THE CUSTOMER STATED THAT UPON INSERTION OF THE RIGHT ANGLE THORACIC CATHETER IT SNAPPED IN HALF. THE SNAP WAS REPORTED AS BEING A CLEAN BREAK. THERE WAS NO HARM TO THE PT AND IT DID NOT DELAY TREATMENT TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
247608 SIL R ANG THORACIC 32FR THORACIC CATHETER KDQ COVIDIEN 8888573055 0270312

Patients

Seq Age Sex Outcome Treatment
1 UNK