UMBILICAL CORD CLAMP 460-00

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05,06,07 report with the FDA on 2014-05-01 for UMBILICAL CORD CLAMP 460-00 manufactured by Unomedical Ltd..

Event Text Entries

[4528552] Product does not grip tightly enough and does not stop the blood flow. This has caused a baby to need blood transfusion in intensive care.
Patient Sequence No: 1, Text Type: D, B5


[11786818] Based on the available information, this event is deemed a serious injury and the device was used on a pt. No additional pt/event details have been provided to date. Should additional information become available a follow-up report will be submitted. A return sample for evaluation is not expected. Convatec will continue to observe for trends regarding these complaint types. This mdr is being reported as a result of a retrospective review of complaint records conducted by convatec for complaints received from may 1, 2011- september 30, 2013. Note: the actual date of event is unknown, so the date used was the date convatec became aware.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3007966929-2014-00015
MDR Report Key3812672
Report Source01,05,06,07
Date Received2014-05-01
Date of Report2011-05-17
Date of Event2011-05-17
Date Mfgr Received2011-05-17
Date Added to Maude2014-05-16
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMATTHEW WALENCIAK
Manufacturer Street200 HEADQUARTERS PARK DRIVE
Manufacturer CitySKILLMAN NJ 08558
Manufacturer CountryUS
Manufacturer Postal08558
Manufacturer Phone9083779293
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUMBILICAL CORD CLAMP
Generic NameOPERATION ACCESSORIES
Product CodeHFW
Date Received2014-05-01
Model Number460-00
Catalog Number460-00
Lot Number1103
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerUNOMEDICAL LTD.
Manufacturer AddressZAVODSKAYA STREET 50 FANIPOL DZERZHINSK DISTRICT MINSK REGION 222750 BO 222750


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2014-05-01

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