MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2014-09-18 for * DYND70104 manufactured by Medline Industries.
[4941554]
Rn prepared enema soap and water in the bucket; as soon as she hung it the handle snapped and broke. She got a second bucket from an unopened case and the same thing happened.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 4112792 |
| MDR Report Key | 4112792 |
| Date Received | 2014-09-18 |
| Date of Report | 2014-09-18 |
| Date of Event | 2014-09-15 |
| Report Date | 2014-09-18 |
| Date Reported to FDA | 2014-09-18 |
| Date Reported to Mfgr | 2014-09-24 |
| Date Added to Maude | 2014-09-24 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | * |
| Generic Name | KIT, ENEMA, (FOR CLEANING PURPOSE) |
| Product Code | FCE |
| Date Received | 2014-09-18 |
| Returned To Mfg | 2014-09-17 |
| Model Number | * |
| Catalog Number | DYND70104 |
| Lot Number | * |
| ID Number | * |
| Operator | NURSE |
| Device Availability | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDLINE INDUSTRIES |
| Manufacturer Address | ONE MEDLINE PLACE MUNDELEIN IL 60060 US 60060 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2014-09-18 |