2007-A BROSELOW TAPE #AE4800

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2009-04-15 for 2007-A BROSELOW TAPE #AE4800 manufactured by Ge.

Event Text Entries

[21284992] This report did not effect any pt care outcome but is a concern to our facility. The manufacturer of the broselow tape suggested to black out the kg/does on the glucagon calculation basis section of the tape. We received a letter from a dr explaining this. We feel this to be a huge safety concern and would like the fda view of this. I have seen no recalls in respect to this. Dates of use: estimate, 2007 - 2009. Diagnosis or reason for use: for pediatric codes.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5010785
MDR Report Key1365313
Date Received2009-04-15
Date of Report2009-04-15
Date of Event2009-03-02
Date Added to Maude2009-05-06
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand Name2007-A BROSELOW TAPE
Generic NameNA
Product CodeFTY
Date Received2009-04-15
Model Number#AE4800
Lot NumberPRODUCT# AE4800
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerGE


Patients

Patient NumberTreatmentOutcomeDate
10 2009-04-15

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