BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BEMIS 2000CC HI-FLOW SUCTION CANISTER

    MDR report key: 3184864 · Received June 12, 2013

    Report

    Report Number
    2133713-2013-00009
    Event Type
    Malfunction
    Date Received
    June 12, 2013
    Date of Event
    May 31, 2013
    Report Date
    June 12, 2013
    Manufacturer
    BEMIS MFG. CO.
    Product Code
    GCX
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KS, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    SERIAL NUMBER (B)(4) CORRESPONDS TO LOTS 20130408, 20130409, 20130410 AND 20130429.

    Description of Event or Problem · 1

    COMPLAINANT STATED SUCTION CANISTER IMPLODED. THERE WERE NO PT CONSEQUENCES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    267685 BEMIS 2000CC HI-FLOW SUCTION CANISTER APPARATUS, VACUUM, SUCTON POWERED GCX BEMIS MFG. CO. 494410 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1