HUDSON ISO-NEB FILTERED NEBULIZER SYSTEM 41755

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2017-02-28 for HUDSON ISO-NEB FILTERED NEBULIZER SYSTEM 41755 manufactured by Teleflex Medical.

Event Text Entries

[68595816] (b)(4). A visual, dimensional, and functional inspection of the device involved in the complaint could not be conducted since the device was not returned to the manufacturer. There is no photo for review. A device history record review shows that the product was assembled and inspected according to our specifications. Customer complaint cannot be confirmed based only on the information provided. In order to perform a proper investigation, and determine the source of the alleged defect reported, it is necessary to evaluate the sample involved on this complaint. If the sample becomes available this investigation will be updated with the evaluation results.
Patient Sequence No: 1, Text Type: N, H10


[68595817] Customer complaint alleges "improper nebulization of the drug, feels like there is a liquid in the mouth, likely due to the presence of large droplets". There was no report of harm or consequence to patient.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004365956-2017-00080
MDR Report Key6365559
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2017-02-28
Date of Report2017-02-13
Date of Event2017-02-03
Date Mfgr Received2017-02-13
Device Manufacturer Date2016-11-01
Date Added to Maude2017-02-28
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 ContactLINDA WOODALL
Manufacturer Street3015 CARRINGTON MILL BLVD
Manufacturer CityMORRISVILLE 27560
Manufacturer CountryUS
Manufacturer Postal27560
Manufacturer Phone9196942566
Manufacturer G1TELEFLEX MEDICAL
Manufacturer StreetPARQUE INDUSTRIAL FINSA
Manufacturer CityNUEVO LAREDO 88275
Manufacturer CountryMX
Manufacturer Postal Code88275
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameHUDSON ISO-NEB FILTERED NEBULIZER SYSTEM
Generic NameFILTERED NEBULIZER
Product CodeCCQ
Date Received2017-02-28
Catalog Number41755
Lot Number74L1600045
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerTELEFLEX MEDICAL
Manufacturer AddressRESEARCH TRIANGLE PARK NC


Patients

Patient NumberTreatmentOutcomeDate
10 2017-02-28

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