PORTEX? SPINAL NEEDLE SETS 100/496/127

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-11-07 for PORTEX? SPINAL NEEDLE SETS 100/496/127 manufactured by Smiths Medical Asd, Inc..

Event Text Entries

[92199349] (b)(6). This device is same and/or similar to a device approved for distribution in the us.
Patient Sequence No: 1, Text Type: N, H10


[92199350] It was reported that a grey, square, plastic part disconnected from the stylet of a spinal needle. This issue occurred during stylet withdrawal. No patient injury was reported and no medical intervention was required.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3012307300-2017-02353
MDR Report Key7007692
Date Received2017-11-07
Date of Report2018-01-08
Date of Event2017-10-16
Date Mfgr Received2018-01-03
Device Manufacturer Date2017-04-13
Date Added to Maude2017-11-07
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 ContactDAVE HALVERSON
Manufacturer Street6000 NATHAN LANE NORTH
Manufacturer CityMINNEAPOLIS MN 55442
Manufacturer CountryUS
Manufacturer Postal55442
Manufacturer Phone7633833310
Manufacturer G1SMITHS MEDICAL INTERNATIONAL LTD.
Manufacturer Street52 GRAYSHILL ROAD
Manufacturer CityCUMBERNAULD, GLASGOW G68 9HQ
Manufacturer CountryUK
Manufacturer Postal CodeG68 9HQ
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NamePORTEX? SPINAL NEEDLE SETS
Generic NameSPINAL ANESTHESIA KIT
Product CodeOFU
Date Received2017-11-07
Returned To Mfg2017-11-13
Catalog Number100/496/127
Lot Number3388088
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSMITHS MEDICAL ASD, INC.
Manufacturer Address6000 NATHAN LANE NORTH MINNEAPOLIS MN 55442 US 55442


Patients

Patient NumberTreatmentOutcomeDate
10 2017-11-07

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