FDA Adverse Event Other Summary report: N

O-Z COIL SPECIAL (OZ C CA2)

MDR report key: 3853768 · Received June 2, 2014

Report

Report Number
1317749-2014-00244
Event Type
Other
Date Received
June 2, 2014
Date of Event
May 26, 2014
Report Date
May 26, 2014
Manufacturer
COVIDIEN
Product Code
MSD
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
NOT APPLICABLE

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 THE CUFF GOT LOOSE AND DIDN'T ADHERE TO THE SKIN. AS A RESULT, THE PT SHOWED SIGNS OF A CLEAR INFECTION AT THE EXIT SITE. THE CATHETER WAS PULLED AND REPLACED WITH A NEW ON 05/19/2014. MEDICAL INTERVENTION: ANTIBIOTICS AND A CATHETER CHANGE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
322515 O-Z COIL SPECIAL (OZ C CA2) DIALYSIS CATHETER MSD COVIDIEN 8888425710 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Life Threatening