BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PALINDROME SAPPHIRE 23/40KT VT

    MDR report key: 3842487 · Received February 20, 2014

    Report

    Report Number
    1317749-2014-00093
    Event Type
    Malfunction
    Date Received
    February 20, 2014
    Date of Event
    September 25, 2013
    Report Date
    February 3, 2014
    Manufacturer
    COVIDIEN
    Product Code
    MSD
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MX
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    AN INVESTIGATION IS CURRENTLY UNDERWAY. UPON COMPLETION, THE RESULTS WILL BE FORWARDED.

    Description of Event or Problem · 1

    IT WAS REPORTED TO COVIDIEN ON (B)(4) 2014 THAT A CUSTOMER HAD AN ISSUE WITH A DIALYSIS CATHETER. THE CUSTOMER STATES THAT THERE WAS BLOOD LEAKAGE FROM A CRACK IN CATHETER. THE CATHETER WAS PLACED ON (B)(4) 2012 IN THE RIGHT INTERNAL JUGULAR VEIN. THE CATHETER WAS IN PLACE FOR 17 MONTHS. THE CATHETER WAS PULLED AND REPLACED, THE PATIENT IS HEALING PROPERLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    106587 PALINDROME SAPPHIRE 23/40KT VT DIALYSIS CATHETER MSD COVIDIEN 8888145048 110410

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK