MAUDE MDR 217145

MDR report key
217145
Report number
MW1016043
Event key
0
Event type
3
Date of event
1999-03-05
Date received
1999-04-01
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
0
Event location
3

Manufacturer Contact#

Report source
P
Manufacturer link flag
N

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DOVERURINARY DRAINAGESHERWOOD MEDICAL CO.FCN*601709808407NY

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
11999-04-010

Event Narratives#

D

Patient 1

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.