FDA Adverse Event
Malfunction
Summary report: N
RLV
MDR report key: 454928
·
Received April 16, 2003
Report
- Report Number
- 1649914-2003-00023
- Event Type
- Malfunction
- Date Received
- April 16, 2003
- Date of Event
- March 8, 2003
- Report Date
- April 16, 2003
- Manufacturer
- QUEST MEDICAL, INC.
- Product Code
- MNJ
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
AT AN AMSECT MEETING, THE CUSTOMER REPORTED LEAKING WITH THE VALVE. THE AMOUNT AND LOCATION IS UNKNOWN. THE CUSTOMER RECEIVES THE VALVE IN A PACK. THE CUSTOMER STATED IT IS FROM AN OLDER LOT-THEY DO NOT ROTATE THEIR PACKS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | RLV | VACCUM RELIEF VALVE | MNJ | QUEST MEDICAL, INC. | 4103202 | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN |