FDA Adverse Event Injury Summary report: N

XPRESS-WAY RX CATHETER, 6FR

MDR report key: 6251140 · Received January 13, 2017

Report

Report Number
3011175548-2017-00001
Event Type
Injury
Date Received
January 13, 2017
Date of Event
December 19, 2016
Report Date
December 28, 2016
Manufacturer
KANEKA PHARMA AMERICA LLC
Product Code
DXE
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
PA, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE REPORT RECEIVED STATED THAT THE X-PRESSWAY DEVICE FILTER WAS CLOGGED. THE ASPIRATE SAT IN THE FILTER. IT REMAINED CLOGGED EVEN AFTER SQUIRTING WITH HEPARINIZED SALINE.

Description of Event or Problem · 1

THE REPORT RECEIVED STATED THAT THE X-PRESSWAY DEVICE FILTER WAS CLOGGED. THE ASPIRATE SAT IN THE FILTER. IT REMAINED CLOGGED EVEN AFTER SQUIRTING WITH HEPARINIZED SALINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
33576 XPRESS-WAY RX CATHETER, 6FR CATHETER, EMBOLECTOMY, DXE KANEKA PHARMA AMERICA LLC T2R6SA4A KPO76557

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention