PRESERVCYT

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2009-08-27 for PRESERVCYT manufactured by Hologic Inc.

Event Text Entries

[16719242] A male pt ingested some preservcyt from the vial. The vial did not contain a pt sample. The pt was seen by a doctor. No antidote was administered. The pt was fine.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1222780-2009-00128
MDR Report Key1458423
Report Source06
Date Received2009-08-27
Date of Report2009-08-26
Date of Event2009-08-17
Date Mfgr Received2009-08-17
Date Added to Maude2009-09-03
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional0
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactJENNIFER SULLIVAN, SPECIALIST
Manufacturer Street250 CAMPUS DRIVE
Manufacturer CityMARLBOROUGH MA 01752
Manufacturer CountryUS
Manufacturer Postal01752
Manufacturer Phone5082638912
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePRESERVCYT
Generic NamePRESERVATIVE, CYTOLOGICAL
Product CodeLEA
Date Received2009-08-27
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerHOLOGIC INC
Manufacturer AddressLONDONDERRY NH US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2009-08-27

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