FDA Adverse Event Other Summary report: N

HEMOCHRON SIGNATURE ELITE WHOLE BLOOD MICROCO

MDR report key: 921745 · Received September 27, 2007

Report

Report Number
2248721-2007-00004
Event Type
Other
Date Received
September 27, 2007
Date of Event
July 13, 2007
Report Date
August 29, 2007
Manufacturer
INTERNATIONAL TECHNIDYNE CORP. (ITC)
Product Code
JPA
PMA / PMN Number
K050016
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

INFORMATION FOR CASE CURRENTLY UNDER REVIEW AND INVESTIGATION BY MANUFACTURER. DEVICE HAS BEEN RETURNED TO ITC FROM USER FACILITY FOR EVALUATION, BUT AT TIME OF THE MDR FILING, EVALUATION IS IN PROCESS.

Description of Event or Problem · 1

A PT UNDERGOING A SCHEDULED CARDIO CATH INTERVENTION REQUIRED COR DURING THE PROCEDURE IN WHICH HEMOCHRON SIGNATURE ELITE WIT ACT-LR WAS UTILIZED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEMOCHRON SIGNATURE ELITE WHOLE BLOOD MICROCO HEMOCHRON SIGNATURE ELITE/ACT-LR ASSAY JPA INTERNATIONAL TECHNIDYNE CORP. (ITC) JACT-LR (ASSAY) NA

Patients

Seq Age Sex Outcome Treatment
1 NA YR Other