MAUDE MDR 388507

MDR report key
388507
Report number
1062385-2002-00013
Event key
0
Event type
3
Date received
2002-12-12
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-0140UNKNNN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12002-12-120

Event Narratives#

D

Patient 1

COMPLAINANT REPORTED THAT BLOOD ENTERED THE CATHETER DURING VASCULAR BRACHY THERAPY PROCEDURE.