FDA Adverse Event Injury Summary report: N

GREATBATCH MEDICAL STEERABLE SHEATH

MDR report key: 7117910 · Received December 14, 2017

Report

Report Number
2183787-2017-00129
Event Type
Injury
Date Received
December 14, 2017
Date of Event
December 2, 2016
Report Date
November 30, 2017
Manufacturer
GREATBATCH MEDICAL
Product Code
DYB
PMA / PMN Number
K061119
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

AS REPORTED THE PATIENT HAD ACCESS SITE COMPLICATIONS (HEMATOMA).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
897450 GREATBATCH MEDICAL STEERABLE SHEATH INTRODUCER, CATHETER DYB GREATBATCH MEDICAL 10876-002 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 83 YR Other