BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ASH SPLIT CATHETER

    MDR report key: 374928 · Received February 1, 2002

    Report

    Report Number
    2518902-2002-00009
    Event Type
    Injury
    Date Received
    February 1, 2002
    Date of Event
    January 7, 2002
    Report Date
    January 8, 2002
    Manufacturer
    MEDCOMP MEDICAL COMPONENTS, INC.
    Product Code
    MPB
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WI, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED BY THE SALES REPRESENTATIVE THAT WHILE THE PATIENT WAS AT HOME, THEIR ASH SPLIT CATHETER CRACKED IN SEVERAL PLACES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ASH SPLIT CATHETER HEMODIALYSIS CATHETER MPB MEDCOMP MEDICAL COMPONENTS, INC. NA M136560

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO Required Intervention