CATHY-CLOSED S.CH14 25CM/78 36047182

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 01,05,06,07,08 report with the FDA on 2014-05-30 for CATHY-CLOSED S.CH14 25CM/78 36047182 manufactured by Unomedical Ltd..

Event Text Entries

[4669160] It was reported "inflation of catheter sleeve (making it difficult to manipulate the catheter due to the air pressure); moisture build-up inside the sleeve". Note: this reported issue occurred on five separate cases.
Patient Sequence No: 1, Text Type: D, B5


[11965044] Based on available information, this event is deemed a reportable malfunction. It was further reported that the "hospital is concerned with infection". Additional event info was provided via email on (b)(6) 2014 informing that they replaced the device due to the continued issues with sleeve inflation and moisture build-up. No info was provided or reported that any infections had occurred to pt(s); they further informed that they cannot determine exact number of pt(s) involved and the product was used in the surgical intensive care unit. They went on the inform that it is unk how long the product was in use prior to the event occurring. Please note: issue occurred on five (5) separate cases. A separate 3500a form has been completed for the other (4) cases under pt identifier(s):# (b)(6). Mfr report(s):# 3007966929-2014-00020, 3007966929-2014-00022, 3007966929-2014-00024 and 3007966929-2014-00026 respectively. (report 1 of 5) no additional pt/ event details have been provided to date. Should additional info become available a follow-up report will be submitted. Note: the actual date of event is unk, so the date used was the date convatec became aware.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3007966929-2014-00018
MDR Report Key3908247
Report Source01,05,06,07,08
Date Received2014-05-30
Date of Report2014-04-30
Date of Event2014-04-30
Date Mfgr Received2014-04-30
Device Manufacturer Date2010-12-01
Date Added to Maude2014-07-16
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, DIRECTOR
Manufacturer Street211 AMERICAN AVENUE
Manufacturer CityGREENSBORO NC 27409
Manufacturer CountryUS
Manufacturer Postal27409
Manufacturer Phone9083779293
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCATHY-CLOSED S.CH14 25CM/78
Generic NameCATHETER, NASAL, OXYGEN
Product CodeBZB
Date Received2014-05-30
Model Number36047182
Catalog Number36047182
Lot Number635441
Device Expiration Date2013-11-01
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
10 2014-05-30

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