MAUDE MDR 8093603

MDR report key
8093603
Report number
1625425-2018-00186
Event key
0
Event type
3
Date of event
2018-10-04
Date received
2018-11-21
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MS. GAIL SMITH
Address
1445 FLAT CREEK ROAD ATHENS TX 75751 US
Phone
214-214-2144
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1SKATER? SINGLE-STEP DRAINAGE CATHETER SET WITH LOCKING PIGTAILDRAINAGE CATHETERSARGON MEDICAL DEVICES INC.GBQ75650602511207840Y R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12018-11-2101. O

Event Narratives#

N

Patient 1

THE EVALUATION OF THIS ISSUE IS IN PROGRESS. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.

D

Patient 1

DUE TO RESISTANCE, IT WAS NOT ABLE TO PULL THE THREAD OUT WHEN REMOVING THE CATHETER AFTER DRAINAGE OF ONE MONTH PERIOD. THE THREAD WAS CUT CLOSE TO THE SKIN SURFACE AND THE REMAINING THREAD WAS LEFT IN THE PATIENT BODY. THE CATHETER HAD PLACED IN A GAL BALDER FOR A MONTH FOR DRAINAGE. NO EXTRA PROCEDURE OR SURGERY IS PLANED TO REMOVE THE REMAINING THREAD FROM THE BODY.