MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-10-03 for OPTIVANTAGE 2926 manufactured by Liebel-flarsheim.
[56799893]
Injected faster than intended. The syringes are being bent.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1518293-2016-00084 |
| MDR Report Key | 5993760 |
| Date Received | 2016-10-03 |
| Date of Report | 2016-10-03 |
| Date of Event | 2016-07-28 |
| Date Mfgr Received | 2016-07-28 |
| Device Manufacturer Date | 2014-09-30 |
| Date Added to Maude | 2016-10-03 |
| 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 | SERVICE PERSONNEL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | FRED RECKELHOFF |
| Manufacturer Street | 2111 E GALBRAITH RD |
| Manufacturer City | CINCINNATI OH 45237 |
| Manufacturer Country | US |
| Manufacturer Postal | 45237 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | OPTIVANTAGE |
| Generic Name | OPTIVANTAGE |
| Product Code | IZQ |
| Date Received | 2016-10-03 |
| Model Number | 2926 |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | LIEBEL-FLARSHEIM |
| Manufacturer Address | 2111 E GALBRAITH RD CINCINNATI OH 45237 US 45237 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-10-03 |