INTRAOPERATRIVE PROBE COVER PC1292

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a consumer,user facility report with the FDA on 2019-05-31 for INTRAOPERATRIVE PROBE COVER PC1292 manufactured by Ecolab.

Event Text Entries

[146711066] It was reported that one day after a procedure, a port placement patient returned with an infected port after the use of a probe cover. The manufacture of the probe cover was unknown. No further patient complications have been reported as a result of this event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number8043817-2019-40019
MDR Report Key8660199
Report SourceCONSUMER,USER FACILITY
Date Received2019-05-31
Date of Report2019-05-31
Date of Event2019-05-16
Date Added to Maude2019-05-31
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameINTRAOPERATRIVE PROBE COVER
Generic NamePROBE COVER
Product CodeKKX
Date Received2019-05-31
Model NumberPC1292
Lot NumberD190229
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerECOLAB
Manufacturer Address1 ECOLAB PLACE ST PAUL MN 55102 US 55102


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2019-05-31

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