SPECTRUM VENTRICLEAR? DRAINAGE CATHETER SET N/A N-VVDC-01-ABRM

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a other report with the FDA on 2016-11-14 for SPECTRUM VENTRICLEAR? DRAINAGE CATHETER SET N/A N-VVDC-01-ABRM manufactured by Cook Inc.

Event Text Entries

[59786500] (b)(4). The event is currently under investigation.
Patient Sequence No: 1, Text Type: N, H10


[59786501] It was reported during removal the catheter broke and remains in the patients cranium. No additional information was available at the time of this report.
Patient Sequence No: 1, Text Type: D, B5


[74270511] Investigation? Evaluation: a review of the complaint history, drawing, instructions for use (ifu), manufacturing instructions, quality control, and trends of the device was conducted during the investigation. The complaint device was not returned therefore, no physical examinations could be performed; however, a document based investigation evaluation was performed. There is no evidence to suggest the product was not made to specifications. The lot number of the device is not known; accordingly a review of the device history record could not be conducted. Based on the information provided, no product returned and the results of our investigation, a definitive root cause could not be determined. We will continue to monitor for similar complaints. Per the quality engineering risk assessment no further action is required.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1820334-2016-01306
MDR Report Key6098450
Report SourceOTHER
Date Received2016-11-14
Date of Report2017-04-24
Date Mfgr Received2017-03-13
Date Added to Maude2016-11-14
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMRS. RITA HARDEN
Manufacturer Street750 DANIELS WAY
Manufacturer CityBLOOMINGTON IN 47404
Manufacturer CountryUS
Manufacturer Postal47404
Manufacturer Phone8123392235
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSPECTRUM VENTRICLEAR? DRAINAGE CATHETER SET
Generic NameNHC CATHETER, VENTRICULAR (CONTAINING ANTIBIOTIC 0R ANTIMICROBIAL AGENTS)
Product CodeNHC
Date Received2016-11-14
Model NumberN/A
Catalog NumberN-VVDC-01-ABRM
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCOOK INC
Manufacturer Address750 DANIELS WAY BLOOMINGTON IN 47404 US 47404


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2016-11-14

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