MAUDE MDR 6330372

MDR report key
6330372
Report number
3007966929-2017-00006
Event key
0
Event type
3
Date received
2017-02-14
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1TBDFFG509047227856N N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-02-140

Event Narratives#

N

Patient 1

BRAND NAME: UNOMETER SAFETI; COMMON DEVICE NAME: DEVICE URINE FLOW RATE MEASURING, NON-ELECTRICAL; PROCODE: FFG. (B)(6). BASED ON THE AVAILABLE INFORMATION, THIS EVENT IS DEEMED A PRODUCT MALFUNCTION. NO PATIENT HARM WAS REPORTED. ADDITIONAL DETAILS HAVE BEEN REQUESTED BUT NOT PROVIDED TO DATE. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, A FOLLOW UP REPORT WILL BE SUBMITTED. (B)(4).

D

Patient 1

COMPLAINT REPORTED BY A DOCTOR THAT "THE URINE DID NOT FLOW INTO THE COLLECTION ROOM" OF THE DEVICE. THE DEVICE WAS REMOVED. NO FURTHER INFORMATION WAS AVAILABLE.

N

Patient 1

(B)(4). A BATCH RECORD REVIEW WAS PERFORMED; AND A NON-CONFORMANCE (NC) FROM A PREVIOUS COMPLAINT WAS OPENED WHICH IS ASSOCIATED WITH THIS REPORTED ISSUE. THE NC HAS BEEN CLOSED AND NO FURTHER INVESTIGATION IS REQUIRED. THE INVESTIGATION CONCLUDED THAT THE LIKELY ROOT CAUSE FOR THE ISSUE, "STOP FLOW BETWEEN PATIENT AND CHAMBER OF THE UNOMETER PRODUCT" CANNOT BE IDENTIFIED BASED ON THE INFORMATION RECEIVED. THIS ISSUE WILL BE MONITORED THROUGH THE POST MARKET PRODUCT MONITORING REVIEW PROCESS. NO ADDITIONAL PATIENT/DETAILS HAS BEEN PROVIDED REGARDING THE REPORTED EVENT. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE AT A LATER DATE, A FOLLOW-UP REPORT WILL BE SUBMITTED. (B)(4).