MAUDE MDR 357329

MDR report key
357329
Report number
1062385-2001-00015
Event key
0
Event type
3
Date of event
2001-09-28
Date received
2001-10-17
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
ADAM LOWE, VP
Address
3890 STEVE REYNOLDS BLVD. NORCROSS GA 30093 US
Phone
770-770-7707
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
140MM BETA-CATH DELIVERY CATHETERCATHETERNOVOSTE CORPORATIONMOU510609-040BCK-0140444111NRN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12001-10-170

Event Narratives#

D

Patient 1

COMPLAINANT REPORTED THAT THE SEAMS OF THE STERILE BAG PROVIDED WITH THE BETA-CATH CATHETER SPLIT READILY WHEN UNFOLDING THE END OF THE BAG, AND THAT THE WHITE TAPE STRIP WAS LOCATED IN THE OPPOSITE/REVERSE LOCATION FROM WHERE IT USUALLY IS.