MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2016-07-20 for CLINIMACS? TUBING SET LS N/A 162-01 manufactured by Miltenyi Biotec Gmbh.
[49980253]
Patient Sequence No: 1, Text Type: N, H10
[49980254]
The customer reported that the clinimacs tubing set ls spike broke at the bubble trap during usage. They informed miltenyi biotec inc. Representative which supported the customer to connect a new spike in a sterile way, so that the cells could be processed as usual.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3005290010-2016-00077 |
| MDR Report Key | 5808561 |
| Report Source | COMPANY REPRESENTATIVE |
| Date Received | 2016-07-20 |
| Date of Report | 2016-07-19 |
| Date of Event | 2016-06-24 |
| Date Mfgr Received | 2016-06-24 |
| Device Manufacturer Date | 2016-02-15 |
| Date Added to Maude | 2016-07-20 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MS NANCY JOHANSEN |
| Manufacturer Street | 85 HAMILTON ST |
| Manufacturer City | CAMBRIDGE MA 02139 |
| Manufacturer Country | US |
| Manufacturer Postal | 02139 |
| Manufacturer Phone | 6172180062 |
| Manufacturer G1 | MILTENYI BIOTEC GMBH |
| Manufacturer Street | FRIEDRICH-EBERT-STRASSE 68 |
| Manufacturer City | BERGISCH GLADBACH, 51429 |
| Manufacturer Country | GM |
| Manufacturer Postal Code | 51429 |
| Single Use | 3 |
| Remedial Action | NO |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | CLINIMACS? TUBING SET LS |
| Generic Name | CLINIMACS? TUBING SET LS |
| Product Code | OVG |
| Date Received | 2016-07-20 |
| Model Number | N/A |
| Catalog Number | 162-01 |
| Lot Number | B2538 |
| Device Expiration Date | 2018-10-10 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MILTENYI BIOTEC GMBH |
| Manufacturer Address | FRIEDRICH-EBERT-STRASSE 68 BERGISCH GLADBACH, 51429 GM 51429 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-07-20 |