FDA Adverse Event Injury Summary report: N

ULTRATHANE COOK - COPE TYPE LOCKING LOOP MULTIPURPOSE DRAINAGE CATHETER

MDR report key: 3760944 · Received April 9, 2014

Report

Report Number
1820334-2014-00152
Event Type
Injury
Date Received
April 9, 2014
Date of Event
February 27, 2014
Report Date
March 14, 2014
Manufacturer
COOK INC
Product Code
GBO
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NZ
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVENT EVALUATION: STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

A (B)(6) MALE PATIENT WITH INVASIVE UROTHELIAL CARCINOMA (T2 TCC BLADDER CARCINOMA) UNDERWENT ONGOING USE OF DRAINAGE CATHETER (LEFT NEPHROSTOMY DRAINAGE CATHETER CAME APART AT CONNECTION BETWEEN CATHETER AND LUER HUB RESULTING IN PATIENT RETURNING TO HOSPITAL'S EMERGENCY DEPARTMENT SO THE DEVICE COULD BE CHANGED. THE PATIENT REQUIRED AN ADDITIONAL PROCEDURE TO REPLACE THE DEVICE THE NEXT DAY ((B)(6) 2014) AND REQUIRED 2 DAYS STAY AS INPATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
213286 ULTRATHANE COOK - COPE TYPE LOCKING LOOP MULTIPURPOSE DRAINAGE CATHETER GBO CATHETER, NEPHROSTOMY, GENERAL AND PLASTIC SURGERY GBO COOK INC NA 3988055

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention