MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-09-05 for UROPASS URETERAL ACCESS SHEATH EG61146BX manufactured by Olympus.
[84951097]
While performing a cysto retrograde pyelogram, the tip of sheath on the ureteral access split while being used.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5071935 |
| MDR Report Key | 6843048 |
| Date Received | 2017-09-05 |
| Date of Report | 2017-08-24 |
| Date of Event | 2017-08-18 |
| Date Added to Maude | 2017-09-05 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| 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 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | UROPASS URETERAL ACCESS SHEATH |
| Generic Name | ENDOSCOPE AND ACCESSORIES |
| Product Code | KNY |
| Date Received | 2017-09-05 |
| Catalog Number | EG61146BX |
| Lot Number | 09F1600052 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | OLYMPUS |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2017-09-05 |