MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-08-23 for JACKSON PRATT DRAIN manufactured by Unknown.
[52764110]
Patient Sequence No: 1, Text Type: N, H10
[52764111]
Noted patient's right leg jp drain was broken at insertion point of patient's skin. Removed internal portion of drain; the entire jp piece was intact.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 5895890 |
| MDR Report Key | 5895890 |
| Date Received | 2016-08-23 |
| Date of Report | 2016-08-18 |
| Date of Event | 2016-08-01 |
| Report Date | 2016-08-18 |
| Date Reported to FDA | 2016-08-18 |
| Date Reported to Mfgr | 2016-08-18 |
| Date Added to Maude | 2016-08-23 |
| 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 | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | JACKSON PRATT DRAIN |
| Generic Name | WOUND DRAIN CATHETER SYSTEM |
| Product Code | OTK |
| Date Received | 2016-08-23 |
| Operator | NURSE |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | UNKNOWN |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-08-23 |