MAUDE MDR 8007288

MDR report key
8007288
Report number
1917413-2018-03660
Event key
0
Event type
3
Date of event
2018-10-04
Date received
2018-10-25
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
BDX BRETT WILKO
Address
9450 SOUTH STATE STREET SANDY UT 84070 US
Phone
801-801-8015
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BD VACUTAINER? GLASS CPT MOLECULAR DIAGNOSTICS TUBELYMPHOCYTE SEPARATION MEDIUMBECTON, DICKINSON & CO.JCF3627538152655R *

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12018-10-2501. O

Event Narratives#

N

Patient 1

A DEVICE EVALUATION IS ANTICIPATED, BUT HAS NOT YET BEGUN. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE FILED.

D

Patient 1

IT WAS REPORTED WITH THE USE OF THE BD VACUTAINER? GLASS CPT MOLECULAR DIAGNOSTICS TUBE THERE WAS AN ISSUE WITH POOR SEPARATION. THERE WAS NO REPORT OF INJURY OR MEDICAL INTERVENTION.