BEUDAMED
    FDA Adverse Event Other Summary report: N

    89-2349 ARTERIOGRAM VALUE SET

    MDR report key: 360217 · Received October 31, 2001

    Report

    Report Number
    1034876-2001-00024
    Event Type
    Other
    Date Received
    October 31, 2001
    Date of Event
    October 1, 2001
    Report Date
    October 31, 2001
    Manufacturer
    DEROYAL INDUSTRIES, INC.
    Product Code
    KDD
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    TUBING FROM DUMP BAG BECAME DISCONNECTED DURING USE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    48683 89-2349 ARTERIOGRAM VALUE SET CBT MANAGED CHOICE BASIN CATH-LAB KDD DEROYAL INDUSTRIES, INC. NA 580933

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other