ASPIRA PERITONEAL DRAINAGE UNKNOWN

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-10-13 for ASPIRA PERITONEAL DRAINAGE UNKNOWN manufactured by Bard Access Systems.

Event Text Entries

[89969514] The information provided by bard represents all of the known information at this time. Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bard. The device has not been returned to the manufacturer for evaluation, as the device remains in the patient. A lot history review (lhr) review is not possible, as no manufacturing lot number has been provided by the complainant. Sample remains in patient.
Patient Sequence No: 1, Text Type: N, H10


[89969515] It was reported that the home care nurse was attempting to drain an aspira peritoneal patient on (b)(6) 2017. The nurse stated this was the first attempt at drainage since catheter placement on (b)(6) 2017. The nurse stated she had tried two drainage kits and noted very little drainage, even though the patient was distended and uncomfortable. She also noted there was leakage coming from the insertion and exit sites of the catheter.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3006260740-2017-01837
MDR Report Key6949746
Date Received2017-10-13
Date of Report2017-10-13
Date of Event2017-09-24
Date Added to Maude2017-10-13
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 ContactSHELLY GILBERT
Manufacturer Street605 N. 5600 W.
Manufacturer CitySALT LAKE CITY UT 84116
Manufacturer CountryUS
Manufacturer Postal84116
Manufacturer Phone8015225640
Manufacturer G1BARD REYNOSA S.A. DE C.V. -9617592
Manufacturer StreetBLVD. MONTEBELLO #1 PARQUE INDUSTRIAL COLONIAL
Manufacturer CityREYNOSA, TAMAULIPAS
Manufacturer CountryMX
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameASPIRA PERITONEAL DRAINAGE
Generic NamePERITONEAL, DRAINAGE CATHETER FOR REFRACTORY ASCITES, LONG-TERM INDWELLING
Product CodePNG
Date Received2017-10-13
Catalog NumberUNKNOWN
Lot NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBARD ACCESS SYSTEMS
Manufacturer Address605 N. 5600 W. SALT LAKE CITY UT 84116 US 84116


Patients

Patient NumberTreatmentOutcomeDate
10 2017-10-13

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