FDA Adverse Event Malfunction Summary report: N

IN SWN NCK CRL CATH 39.1CM 2CF

MDR report key: 891257 · Received August 8, 2007

Report

Report Number
1317749-2007-00073
Event Type
Malfunction
Date Received
August 8, 2007
Date of Event
June 1, 2007
Report Date
July 23, 2007
Manufacturer
COVIDIEN
Product Code
FJS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN INVESTIGATION IS CURRENTLY UNDERWAY, UPON COMPLETION THE RESULTS WILL BE FORWARDED.

Description of Event or Problem · 1

IT WAS REPORTED TO COVIDIEN THAT A CUSTOMER HAD A PROBLEM WITH A DIALYSIS CATHETER. THE CUSTOMER STATED, THAT THE PD CATHETER WAS PLACED IN PATIENT, WHEN THEY TRIED TO USE THE CATHETER A COUPLE OF DAYS LATER IT DID NOT WORK SO THEY HAD TO REPEAT THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 IN SWN NCK CRL CATH 39.1CM 2CF DIALYSIS CATHETER FJS COVIDIEN 8888413100 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 YR