URINE METER 158101210190

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-09-20 for URINE METER 158101210190 manufactured by .

Event Text Entries

[88062774] (b)(6). (b)(4). Based on the available information, this event is deemed a product malfunction. Additional details have been requested but not provided to date. Should additional information become available, a follow up report will be submitted. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[88062775] It was reported that the bags had black spots in the used measuring chamber of the device. The distributor stated "it is suspected molds. " photos depicting the reported event were provided for review. No further details have been provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3007966929-2017-00049
MDR Report Key6879663
Date Received2017-09-20
Date Mfgr Received2017-11-29
Date Added to Maude2017-09-20
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
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameURINE METER
Generic NameDEVICE, URINE FLOW RATE MEASURING, NON-ELECTRICAL, DISPOSABLE
Product CodeFFG
Date Received2017-09-20
Returned To Mfg2017-09-12
Model Number158101210190
Lot Number310323
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0


Patients

Patient NumberTreatmentOutcomeDate
10 2017-09-20

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