FDA Adverse Event Summary report: N

10 FRENCH SHEATH

MDR report key: 9838 · Received August 2, 1993

Report

Report Number
9838
Date Received
August 2, 1993
Report Date
July 23, 1993
Manufacturer
UNIVERSAL MEDICAL INSTRUMENT CORPORATION
Product Code
EYT
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

DURING A PTCA PROCEDURE, A 10 FRENCH SHEATH WAS INSERTED TO LEFT FEMORAL ARTERY. WHILE THE PHYSICIAN WAS INSERTING A CATHETER INTO THE SHEATH, THE SHEATH CAME APART AT THE CLEAR HUB CONNECTION. A SMALL WHITE PLASTIC INTRODUCER REMAINED IN THE PATIENT AND HAD TO BE IMMEDIATELY REMOVED OVER A GUIDEWIRE. IN ADDITION, TWO OTHER SHEATHS CAME APART WHILE BEING REMOVED FROM TWO OTHER PATIENTS.INVALID DATA - REGARDING SINGLE USE LABELING OF DEVICE. PATIENT MEDICAL STATUS PRIOR TO EVENT: INVALID DATA. INVALID DATA - REGARDING MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY.INVALID DATA - REGARDING WHETHER EVENT PRESENTS IMMINENT HAZARD. INVALID DATA - WHETHER DEVICE USED AS LABELED/INTENDED.INVALID DATA - REGARDING EVALUATION BY USER AFTER EVENT. METHOD OF EVALUATION: INVALID DATA. RESULTS OF EVALUATION: INVALID DATA. CONCLUSION: INVALID DATA. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: INVALID DATA. CORRECTIVE ACTIONS: NO DATA. INVALID DATA - ON DEVICE DESTROYED/DISPOSED OF STATUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 10 FRENCH SHEATH EYT UNIVERSAL MEDICAL INSTRUMENT CORPORATION 150006

Patients

Seq Age Sex Outcome Treatment
1 UNK Invalid Data