FDA Adverse Event
Malfunction
Summary report: N
E REIN MUR 7.5MM 71-13265
MDR report key: 5290033
·
Received December 11, 2015
Report
- Report Number
- 9611710-2015-40023
- Event Type
- Malfunction
- Date Received
- December 11, 2015
- Report Date
- November 6, 2015
- Manufacturer
- UNOMEDICAL SDN BHD
- Product Code
- BTR
- PMA / PMN Number
- K962389
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
CONVATEC IS SUBMITTING THIS REPORT AS A RESULT OF ACTIVITIES RELATED TO CONVATEC REMEDIATION PROTOCOL (B)(4).
Description of Event or Problem · 1
IT WAS REPORTED FOREIGN SUBSTANCE IN THE PACKAGE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 820762 | E REIN MUR 7.5MM 71-13265 | TUBE, TRACHEAL (W/WO CONNECTOR) | BTR | UNOMEDICAL SDN BHD | 61214075IJ | 610338R001 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |