MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-09-27 for PORT-A-CATH 1969378 manufactured by Allergan/apollo Endosurgery Inc..
[87728878]
Md unable to access port in office. Patient returned to operating room and device found to have flipped 90 degrees, becoming inaccessible.
Patient Sequence No: 1, Text Type: D, B5
Report Number | MW5072495 |
MDR Report Key | 6897746 |
Date Received | 2017-09-27 |
Date of Report | 2017-09-25 |
Date of Event | 2017-09-21 |
Date Added to Maude | 2017-09-27 |
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 |
Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
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 | PORT-A-CATH |
Generic Name | LAPAROSCOPIC BAND SYSTEM ACCESS |
Product Code | LNY |
Date Received | 2017-09-27 |
Model Number | 1969378 |
Operator | HEALTH PROFESSIONAL |
Device Availability | Y |
Device Eval'ed by Mfgr | I |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | ALLERGAN/APOLLO ENDOSURGERY INC. |
Manufacturer Address | SANTA BARBARA CA 93111 US 93111 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Other | 2017-09-27 |