FDA Adverse Event
Malfunction
Summary report: N
NATURA
MDR report key: 8864670
·
Received August 6, 2019
Report
- Report Number
- 9618003-2019-04975
- Event Type
- Malfunction
- Date Received
- August 6, 2019
- Manufacturer
- CONVATEC DOMINICAN REPUBLIC INC
- Product Code
- EXE
- PMA / PMN Number
- EXEMPT
- Report Source
- Manufacturer report
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(6). BASED ON THE AVAILABLE INFORMATION, THIS EVENT IS DEEMED TO BE A REPORTABLE MALFUNCTION. TO DATE NO ADDITIONAL INFORMATION HAS BEEN RECEIVED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, A FOLLOW-UP REPORT WILL BE SUBMITTED. (B)(4).
Description of Event or Problem · 1
IT WAS REPORTED THAT 111 PIECES HAVE "OFF CENTER STARTER HOLE". THESE PRODUCTS WERE NOT USED BY ANY PATIENTS, NO HARM REPORTED. NO PHOTOGRAPH DEPICTING THE REPORTED COMPLAINT ISSUE WAS SUBMITTED BY THE COMPLAINANT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 657547 | NATURA | PROTECTOR, OSTOMY | EXE | CONVATEC DOMINICAN REPUBLIC INC | 413181 | 8L02242 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |