FDA Adverse Event Malfunction Summary report: N

PERIFIX®

MDR report key: 8769250 · Received July 8, 2019

Report

Report Number
9610825-2019-00244
Event Type
Malfunction
Date Received
July 8, 2019
Date of Event
June 6, 2019
Report Date
July 8, 2019
Manufacturer
B. BRAUN MELSUNGEN AG
Product Code
OGE
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT HAS BEEN IDENTIFIED AS B. BRAUN (B)(4) INTERNAL REPORT # (B)(4) - EVENT 1. AS WE RECEIVED NO SAMPLE, AN EXAMINATION WAS NOT POSSIBLE. A REVIEW OF THE BATCH AND MANUFACTURING DOCUMENTATION COULD NOT BE PERFORMED, AS NO BATCH NUMBER HAS BEEN PROVIDED. THE PRODUCT DESIGN IS BEING UPDATED TO INCREASE THE FORCE REQUIRED TO OPEN THE CATHETER CONNECTOR UNDER CHANGE CONTROL: (B)(4). NOTE: THIS REPORT IS BEING FILED FOR AN ITEM NUMBER THAT IS NOT SOLD IN THE UNITED STATES, HOWEVER SIMILAR ITEMS ARE SOLD IN THE UNITED STATES BY B. BRAUN MEDICAL, INC.

Description of Event or Problem · 1

EVENT 1: AS REPORTED BY THE USER FACILITY (TRANSLATION OF USER FACILITY INFORMATION BY BBM SALES ORGANIZATION IN (B)(4)): CLIP DETACHED. THERE IS A SERIES OF COMPLAINTS THAT THE ALLIGATOR CLIP COMES OFF AFTER EPIDURAL SURGERY. THREE CASES HAVE BEEN REPORTED SINCE MAY. NO SAMPLE IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
561054 PERIFIX® EPIDURAL ANESTHESIA KIT OGE B. BRAUN MELSUNGEN AG N/A

Patients

Seq Age Sex Outcome Treatment
1