MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 1999-05-04 for FILIFORM WITH SPIRAL TIP, PHILLIPS CATHETER FOLLOWER 343104, 346126 manufactured by Rusch Inc..
[129042]
It is reported that filiform and follower became separated upon removal from the pt.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 2429473-1999-00037 |
MDR Report Key | 222416 |
Report Source | 06 |
Date Received | 1999-05-04 |
Date of Report | 1999-05-04 |
Date of Event | 1999-04-16 |
Date Mfgr Received | 1999-04-27 |
Date Added to Maude | 1999-05-12 |
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 | 0 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 0 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | FILIFORM WITH SPIRAL TIP, PHILLIPS CATHETER FOLLOWER |
Generic Name | FILIFORM AND FOLLOWER |
Product Code | FBW |
Date Received | 1999-05-04 |
Returned To Mfg | 1999-04-27 |
Model Number | NA |
Catalog Number | 343104, 346126 |
Lot Number | UNK |
ID Number | NA |
Operator | HEALTH PROFESSIONAL |
Device Availability | R |
Device Eval'ed by Mfgr | Y |
Implant Flag | N |
Date Removed | A |
Device Sequence No | 1 |
Device Event Key | 215697 |
Manufacturer | RUSCH INC. |
Manufacturer Address | 2450 MEADOWBROOK PARKWAY DULUTH GA 30096 US |
Baseline Brand Name | FILIFORM WITH SPIRAL TIP, PHILLIPS CATHETER FOLLOWER |
Baseline Generic Name | FILIFORM AND FOLLOWER |
Baseline Model No | NA |
Baseline Catalog No | 343104, 346126 |
Baseline ID | NA |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Other | 1999-05-04 |