BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AORTIC PERFUSION CANNULA

    MDR report key: 36013 · Received August 22, 1996

    Report

    Report Number
    1713910-1996-00018
    Event Type
    Malfunction
    Date Received
    August 22, 1996
    Date of Event
    July 15, 1996
    Report Date
    August 22, 1996
    Manufacturer
    RESEARCH MEDICAL INC.
    Product Code
    DWF
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AU
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    FOLLOWING CANNULATION A CRACK IN THE 3/8" STRAIGHT CONNECTOR WAS NOTICED. THE CANNULATOR WAS REPLACED WITH NO ADVERSE EFFECT TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AORTIC PERFUSION CANNULA PERFUSION CANNULA DWF RESEARCH MEDICAL INC. NA 85660

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention