FDA Adverse Event Malfunction Summary report: N

HUDSON NEONATE DUAL HEATED DUAL DRAIN

MDR report key: 3970595 · Received June 2, 2014

Report

Report Number
3004365956-2014-00206
Event Type
Malfunction
Date Received
June 2, 2014
Date of Event
May 16, 2014
Report Date
May 16, 2014
Manufacturer
TELEFLEX
Product Code
CAG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

A VISUAL, FUNCTIONAL AND DIMENSIONAL INSPECTION OF THE PRODUCT INVOLVED IN THE COMPLAINT COULD NOT BE CONDUCTED SINCE THE PRODUCT WAS NOT RETURNED. A DHR (DEVICE HISTORY RECORD) REVIEW COULD NOT BE CONDUCTED SINCE THE LOT NUMBER WAS NOT PROVIDED. NO CORRECTIVE ACTION CAN BE ESTABLISHED SINCE THE SAMPLE IS NOT AVAILABLE TO PERFORM AN INVESTIGATION AND DETERMINE THE SOURCE OF DEFECT REPORTED. THIS CUSTOMER COMPLAINT CAN NOT BE CONFIRMED DUE TO THE LACK OF PRODUCT SAMPLE TO PERFORM AN INVESTIGATION AND DETERMINE THE SOURCE OF DEFECT REPORTED. IF DEFECTIVE SAMPLE BECOMES AVAILABLE AT A LATER DATE, THIS COMPLAINT WILL BE RE-OPENED.

Description of Event or Problem · 1

THE EVENT IS REPORTED AS: THE CUSTOMER ALLEGES THAT THE COLUMN DID NOT WORK AFTER SET-UP. THE ALLEGED FAILURE OCCURRED PRIOR TO PATIENT USE DURING PRE-TESTING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
320900 HUDSON NEONATE DUAL HEATED DUAL DRAIN BREATHING CIRCUIT CAG TELEFLEX

Patients

Seq Age Sex Outcome Treatment
1