BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AORTIC PERFUSION CANNULA

    MDR report key: 44351 · Received October 8, 1996

    Report

    Report Number
    1713910-1996-00028
    Event Type
    Malfunction
    Date Received
    October 8, 1996
    Date of Event
    September 12, 1996
    Report Date
    October 8, 1996
    Manufacturer
    RESEARCH MEDICAL INC.
    Product Code
    DQR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AS
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    FOLLOWING CANNULATION IT WAS DISCOVERED THE CONNECTOR HAD CRACKED. THE M.D. USED A HOSP DESIGNED OBTURATOR FOR INSERTION OF THE CANNULA.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AORTIC PERFUSION CANNULA PERFUSION CANNULA DQR RESEARCH MEDICAL INC. NA 87396

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other