FDA Adverse Event Malfunction Summary report: N

CRUISER-18

MDR report key: 4110268 · Received September 12, 2014

Report

Report Number
3006010712-2014-00007
Event Type
Malfunction
Date Received
September 12, 2014
Date of Event
July 24, 2014
Report Date
August 15, 2014
Manufacturer
BRIVANT, LTD.
Product Code
DQX
PMA / PMN Number
K102211
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

THE COATING FLAKED OFF THE WIRE DURING REINTRODUCTION OF THE WIRE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
565172 CRUISER-18 GUIDEWIRE DQX BRIVANT, LTD. 357261 10326888

Patients

Seq Age Sex Outcome Treatment
1 Other