MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,distri report with the FDA on 2019-11-20 for PLEURX PERITONEAL CATHETER MINI KIT 50-9050 manufactured by Carefusion, Inc.
Report Number | 1625685-2019-00129 |
MDR Report Key | 9351498 |
Report Source | COMPANY REPRESENTATIVE,DISTRI |
Date Received | 2019-11-20 |
Date of Report | 2019-11-20 |
Date of Event | 2019-11-11 |
Date Mfgr Received | 2019-11-14 |
Date Added to Maude | 2019-11-20 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | BDX ANNA WEHRHEIM |
Manufacturer Street | 75 N. FAIRVIEW DRIVE |
Manufacturer City | VERNON HILLS IL 60061 |
Manufacturer Country | US |
Manufacturer Postal | 60061 |
Manufacturer Phone | 8015652341 |
Manufacturer G1 | CAREFUSION, INC |
Manufacturer Street | 400 EAST FOSTER RD |
Manufacturer City | MANNFORD OK 74044 |
Manufacturer Country | US |
Manufacturer Postal Code | 74044 |
Single Use | 3 |
Remedial Action | OT |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | PLEURX PERITONEAL CATHETER MINI KIT |
Generic Name | PERITONEAL, DRAINAGE CATHETER FOR REFRACTORY ASCITES, LONG-TERM INDWELLING |
Product Code | PNG |
Date Received | 2019-11-20 |
Catalog Number | 50-9050 |
Lot Number | UNKNOWN |
Operator | LAY USER/PATIENT |
Device Availability | * |
Device Eval'ed by Mfgr | R |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | CAREFUSION, INC |
Manufacturer Address | 75 N. FAIRVIEW DRIVE VERNON HILLS IL 60061 US 60061 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Other | 2019-11-20 |