FDA Adverse Event Malfunction Summary report: N

THERMODILUTION BALLOON CATHETER

MDR report key: 368362 · Received December 20, 2001

Report

Report Number
2243801-2001-00030
Event Type
Malfunction
Date Received
December 20, 2001
Date of Event
October 11, 2001
Report Date
December 17, 2001
Manufacturer
B. BRAUN MEDICAL INC./HOSPITAL DIVISION
Product Code
DYG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

RETURN REASON: PRESSURE WAVES DID NOT APPEAR ON MONITOR. ANALYSIS: INVESTIGATION FOUND WIRE BROKE OFF AT SOLDER AREA. ALSO NOTE, STOPCOCK IS CRACKED. ORIGIN UNKNOWN. REMEDIAL ACTION: MANUFACTURING AND QUALITY ASSURANCE HAVE BEEN NOTIFIED. EACH THERMISTOR IS 100% VISUALLY AND CONTINUITY TESTED. BOTH THE FREQUENCY AND SEVERITY TO THIS TYPE OF INCIDENT WILL BE CLOSELY MONITORED TO DETERMINE IF FURTHER REMEDIAL ACTION IS NECESSARY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
57776 THERMODILUTION BALLOON CATHETER FLOW-DIRECTED BALLOON CATHETER DYG B. BRAUN MEDICAL INC./HOSPITAL DIVISION TD-110-7H 0060183412

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other