MAUDE MDR 423547

MDR report key
423547
Report number
1062385-2002-00015
Event key
0
Event type
3
Date of event
2001-10-08
Date received
2002-10-17
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 RA
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
1ALPHA IV REV.3 40MM ACTIVE TRANSFER DEVICETRANSFER DEVICENOVOSTE CORP.MOUA1733WLC-0001-042NAP0000NYR

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12002-10-170

Event Narratives#

D

Patient 1

DIFFICULTY RETURNING SOURCES TO THE TRANSFER DEVICE. SOURCE CONTAMINATED IN CLOSED SYSTEM WAS COMPROMISED. ALL RADIOACTIVE MATERIALS WERE POSITIVELY IDENTIFIED AND ACCOUNTED FOR.