UMBILICAL CABLE M004RAUMBILICAL20 RAUMBILICAL2

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2017-12-20 for UMBILICAL CABLE M004RAUMBILICAL20 RAUMBILICAL2 manufactured by Arden Hills, Mn.

Event Text Entries

[95672261] The device has not been received for analysis. Upon receipt and completion of the failure analysis of the complaint device, if there is any further relevant information from that review, a supplemental medwatch will be filed. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[95672262] Same case as mdr: 2134265-2017-12778. It was reported that foreign matter was present. A rhythmia umbilical cable st and intellamap orion? Were selected to be used in a procedure however it was noticed that when disconnecting the catheter from the umbilical cable a the connector was wet on one part with some oily liquid. "it was not clear if this came from the catheter or from the cable. " both the umbilical cable and orion were replaced to complete the procedure. No patient complications were reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2134265-2017-12777
MDR Report Key7134090
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2017-12-20
Date of Report2017-12-04
Date of Event2017-11-27
Date Mfgr Received2018-01-18
Date Added to Maude2017-12-20
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
Manufacturer ContactEMP. SONALI ARANGIL
Manufacturer StreetONE SCIMED PLACE
Manufacturer CityMAPLE GROVE MN 55311
Manufacturer CountryUS
Manufacturer Postal55311
Manufacturer Phone7634941700
Manufacturer G1ARDEN HILLS, MN
Manufacturer Street4100 HAMLINE AVENUE
Manufacturer CityST. PAUL MN 55112
Manufacturer CountryUS
Manufacturer Postal Code55112
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUMBILICAL CABLE
Generic NameCABLE, ELECTRODE
Product CodeIKD
Date Received2017-12-20
Returned To Mfg2018-01-03
Model NumberM004RAUMBILICAL20
Catalog NumberRAUMBILICAL2
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerARDEN HILLS, MN
Manufacturer Address4100 HAMLINE AVENUE ST. PAUL MN 55112 US 55112


Patients

Patient NumberTreatmentOutcomeDate
10 2017-12-20

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