PILLING LEMOLE-PILL VALVE RET SET #1 341501

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06,07 report with the FDA on 2013-01-03 for PILLING LEMOLE-PILL VALVE RET SET #1 341501 manufactured by Teleflex.

Event Text Entries

[19998975] The event is reported as: alleged issue: customer alleges that the clamps wouldn't stay tight during a procedure. Staff had to keep re-tightening the clamps. No pt injury reported. Pt current condition is fine.
Patient Sequence No: 1, Text Type: D, B5


[20166746] Sample received my mfr, but investigation is incomplete at time of this report.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1044475-2013-00001
MDR Report Key2901473
Report Source06,07
Date Received2013-01-03
Date of Report2012-12-11
Date of Event2012-12-06
Date Mfgr Received2012-12-11
Date Added to Maude2013-03-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactJASMINE BROWN
Manufacturer StreetPO BOX 12600
Manufacturer CityDURHAM NC 27709
Manufacturer CountryUS
Manufacturer Postal27709
Manufacturer Phone9193614124
Manufacturer G1TELEFLEX
Manufacturer Street2917 WECK DR.
Manufacturer CityRESEARCH TRIANGLE PARK NC 27709
Manufacturer CountryUS
Manufacturer Postal Code27709
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NamePILLING LEMOLE-PILL VALVE RET SET #1
Generic NameRETRACTOR
Product CodeEIG
Date Received2013-01-03
Returned To Mfg2012-12-13
Catalog Number341501
OperatorOTHER
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerTELEFLEX
Manufacturer AddressRESEARCH TRIANGLE PARK NC US


Patients

Patient NumberTreatmentOutcomeDate
10 2013-01-03

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