FDA Adverse Event Malfunction Summary report: N

ORTHOPAT PERIOPERATIVE AUTOTRANSFUSION SYSTEM

MDR report key: 3243158 · Received July 18, 2013

Report

Report Number
1219343-2013-00056
Event Type
Malfunction
Date Received
July 18, 2013
Date of Event
June 21, 2013
Report Date
June 21, 2013
Manufacturer
HAEMONETICS CORP.
Product Code
CAC
PMA / PMN Number
K992723
Removal / Correction Number
1219343-04/29/2011-001-R
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
EZ
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN RETURNED FOR EVALUATION. A FOLLOW UP REPORT WILL BE FILED WHEN THE EVALUATION RESULTS ARE AVAILABLE. (B)(4).

Description of Event or Problem · 1

HAEMONECTICS RECEIVED A COMPLAINT ON (B)(4) 2013 FOR AN ORTHOPAT DEVICE WITH THE DESCRIPTION "BLOOD IN CENTRIFUGE". NO PATIENT OR OPERATOR INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
335386 ORTHOPAT PERIOPERATIVE AUTOTRANSFUSION SYSTEM CAC HAEMONETICS CORP.

Patients

Seq Age Sex Outcome Treatment
1