DOVER * 601709

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1999-04-01 for DOVER * 601709 manufactured by Sherwood Medical Co..

Event Text Entries

[131142] Pt had foley catheter placed in emergency room. Drainage bag had a slow leak at drain spout. New cystoflo bag applied. Package not available as product put in another department.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1016043
MDR Report Key217145
Date Received1999-04-01
Date of Report1999-04-01
Date of Event1999-03-05
Date Added to Maude1999-04-06
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA0
Report to FDA0
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameDOVER
Generic NameURINARY DRAINAGE
Product CodeFCN
Date Received1999-04-01
Model Number*
Catalog Number601709
Lot Number808407
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key210632
ManufacturerSHERWOOD MEDICAL CO.
Manufacturer Address1915 OLIVE ST. ST. LOUIS MO 631031642 US


Patients

Patient NumberTreatmentOutcomeDate
10 1999-04-01

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