MICROBORE EXTENSION SET, 60IN 60ES

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-10-19 for MICROBORE EXTENSION SET, 60IN 60ES manufactured by Covidien.

Event Text Entries

[57923009] An investigation is currently underway. Upon completion, the results will be forwarded.
Patient Sequence No: 1, Text Type: N, H10


[57923010] It was reported to covidien on 10/14/2016 that a customer had an issue with an extension set. The customer reports that the extension set is bonded together and will not allow fluids to pass.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9612030-2016-00535
MDR Report Key6041940
Date Received2016-10-19
Date of Report2016-10-14
Date of Event2016-10-14
Date Mfgr Received2016-10-14
Date Added to Maude2016-10-19
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactEDWARD ALMEIDA
Manufacturer Street15 HAMPSHIRE STREET
Manufacturer CityMANSFIELD MA 02048
Manufacturer CountryUS
Manufacturer Postal02048
Manufacturer Phone5084524151
Manufacturer G1COVIDIEN
Manufacturer StreetCALLE 9 SUR NO. 125 CUIDAD INDUSTRIAL
Manufacturer CityTIJUANA
Manufacturer CountryMX
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameMICROBORE EXTENSION SET, 60IN
Generic NameEXTENSION SET
Product CodeFPK
Date Received2016-10-19
Model Number60ES
Catalog Number60ES
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCOVIDIEN
Manufacturer AddressCALLE 9 SUR NO. 125 CUIDAD INDUSTRIAL TIJUANA MX


Patients

Patient NumberTreatmentOutcomeDate
10 2016-10-19

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