MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06,07 report with the FDA on 2009-12-07 for HUDSON ONE WAY VALVE, FEMALE TO MALE 1665 manufactured by Teleflex Medical.
[1514495]
The event is reported as: the one way valve is positioned backwards. No pt injury reported.
Patient Sequence No: 1, Text Type: D, B5
[8504595]
Device evaluated by mfr, the device sample is available for eval. The device sample was not returned for eval at the time of this report.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 3004365956-2009-00071 |
| MDR Report Key | 1556501 |
| Report Source | 05,06,07 |
| Date Received | 2009-12-07 |
| Date of Report | 2009-11-10 |
| Date of Event | 2009-11-10 |
| Date Mfgr Received | 2009-11-10 |
| Date Added to Maude | 2010-08-25 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | ANELA BROWN, MANAGER |
| Manufacturer Street | P.O. BOX 12600 |
| Manufacturer City | RTP NC 27709 |
| Manufacturer Country | US |
| Manufacturer Postal | 27709 |
| Manufacturer Phone | 9194334901 |
| Manufacturer G1 | TELEFLEX MEDICAL |
| Manufacturer Street | AVE. INDUSTRIAS NO.5954 PARQUE INDUSTRIAL FINSA |
| Manufacturer City | NUEVO LAREDO, TAMAULIPAS 88275 |
| Manufacturer Country | MX |
| Manufacturer Postal Code | 88275 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Removal Correction Number | NA |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | HUDSON ONE WAY VALVE, FEMALE TO MALE |
| Generic Name | ONE WAY VALVE |
| Product Code | CBP |
| Date Received | 2009-12-07 |
| Model Number | NA |
| Catalog Number | 1665 |
| Lot Number | 02J09 |
| ID Number | NA |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Age | DA |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | TELEFLEX MEDICAL |
| Manufacturer Address | NUEVO LAREDO MX |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2009-12-07 |