FDA Adverse Event Malfunction Summary report: N

COOK TURBO-FLO HD HEMODIALYSIS CATHETER TRAY

MDR report key: 7523097 · Received May 17, 2018

Report

Report Number
1820334-2018-01480
Event Type
Malfunction
Date Received
May 17, 2018
Date of Event
April 22, 2015
Report Date
May 17, 2018
Manufacturer
COOK INC
Product Code
MPB
UDI-DI
00827002350892
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

COMMON NAME: MPB CATHETER, HEMODIALYSIS, NON-IMPLANTED. PRODUCT CODE: MPB. THIS MDR IS BEING FILED AFTER THE ASSOCIATED COMPLAINT WAS REVIEWED UNDER REMEDIATION PROTOCOL (B)(4), COMPLAINT/MDR RETROSPECTIVE REVIEW AND REMEDIATION AND REASSESSED AS REPORTABLE. ADDITIONAL COMPLAINT INVESTIGATION AND RECORD REMEDIATION WAS NOT PERFORMED.

Description of Event or Problem · 1

THE COMPLAINANT REPORTED THE COOK TURBO-FLO HD HEMODIALYSIS CATHETER WAS BEING USED FOR CONTINUOUS RENAL REPLACEMENT THERAPY THROUGH THE RIGHT SUBCLAVIAN. THE DILATOR TIP BROKE DURING INSERTION. HOWEVER, THE PRODUCT PROBLEM DID NOT RESULT IN ANY DEVICE PIECES BEING LEFT WITHIN THE PATIENT OR OTHER SERIOUS INJURIES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
366595 COOK TURBO-FLO HD HEMODIALYSIS CATHETER TRAY MPB COOK INC G35089 00827002350892

Patients

Seq Age Sex Outcome Treatment
1