MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,user f report with the FDA on 2017-07-24 for ARGYLE 8888750018 manufactured by Covidien.
[80763766]
A good faith effort will be made to obtain the applicable information relevant to the report. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[80763767]
The customer states that the edlich gastric lavage tube was bent and crimped.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1282497-2017-05237 |
| MDR Report Key | 6735330 |
| Report Source | COMPANY REPRESENTATIVE,USER F |
| Date Received | 2017-07-24 |
| Date of Report | 2017-11-21 |
| Date Mfgr Received | 2017-08-21 |
| Date Added to Maude | 2017-07-24 |
| 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 STREET |
| Manufacturer City | MANSFIELD MA 02048 |
| Manufacturer Country | US |
| Manufacturer Postal | 02048 |
| Manufacturer Phone | 5084524151 |
| Manufacturer G1 | COVIDIEN |
| Manufacturer Street | 37 INSURGENTES BLVD A LA P, LA MESA |
| Manufacturer City | TIJUANA 22225 |
| Manufacturer Country | MX |
| Manufacturer Postal Code | 22225 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ARGYLE |
| Generic Name | CATHETER (GASTRIC, COLONIC, ETC.), IRRIGATION AND ASPIRATION |
| Product Code | KDH |
| Date Received | 2017-07-24 |
| Returned To Mfg | 2017-07-27 |
| Model Number | 8888750018 |
| Catalog Number | 8888750018 |
| Lot Number | 162810001 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | COVIDIEN |
| Manufacturer Address | 37 INSURGENTES BLVD A LA P, LA MESA TIJUANA 22225 MX 22225 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-07-24 |