BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALL SILICONE CATHETER

    MDR report key: 3831860 · Received March 6, 2014

    Report

    Report Number
    1018233-2014-00055
    Event Type
    Malfunction
    Date Received
    March 6, 2014
    Report Date
    February 14, 2014
    Manufacturer
    PRODUCTOS PARA EL CUIDADO DE LA SALUD
    Product Code
    EZC
    PMA / PMN Number
    UNK
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NH, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    INVESTIGATION IS STILL IN PROGRESS. ONCE THE INVESTIGATION IS COMPLETE, A SUPPLEMENTAL REPORT WILL BE FILED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A CUFF ROLL WAS NOTED ON THE BALLOON UPON CATHETER REMOVAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    135811 ALL SILICONE CATHETER EZC PRODUCTOS PARA EL CUIDADO DE LA SALUD NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1