MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2016-11-18 for NS-3631 N-STER DISPOSABLE 31159422 manufactured by Covidien.
[60370588]
Submit date: 11/18/2016. An investigation is currently underway. Upon completion, the results will be forwarded. Mansfield product monitoring has contacted the customer on 11/16/2016, 11/17/2016, and 11/18/2016. To date, no response has been received. If additional pertinent information becomes available, the report will be updated.
Patient Sequence No: 1, Text Type: N, H10
[60370589]
It was reported to covidien on (b)(6) 2016 that an issue occurred with an enteral feeding pump. The customer reports two cracked light handle covers.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9612030-2016-00664 |
| MDR Report Key | 6112843 |
| Report Source | DISTRIBUTOR |
| Date Received | 2016-11-18 |
| Date of Report | 2016-10-19 |
| Date of Event | 2016-10-13 |
| Date Mfgr Received | 2016-10-19 |
| Date Added to Maude | 2016-11-18 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | EDWARD ALMEIDA |
| Manufacturer Street | 15 HAMPSHIRE ST |
| Manufacturer City | MANSFIELD MA 02048 |
| Manufacturer Country | US |
| Manufacturer Postal | 02048 |
| Manufacturer Phone | 5084524151 |
| Manufacturer G1 | COVIDIEN |
| Manufacturer Street | CALLE 9 SUR NO. 125 CUIDAD INDUSTRIAL |
| Manufacturer City | TIJUANA |
| Manufacturer Country | MX |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | NS-3631 N-STER DISPOSABLE |
| Generic Name | LITE GLOVE |
| Product Code | LYU |
| Date Received | 2016-11-18 |
| Model Number | 31159422 |
| Catalog Number | 31159422 |
| Lot Number | ASKU |
| Device Availability | N |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | COVIDIEN |
| Manufacturer Address | CALLE 9 SUR NO. 125 CUIDAD INDUSTRIAL TIJUANA MX |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-11-18 |