EPIDURAL CATHETERIZATION KIT UR-05501-FR1

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional,u report with the FDA on 2020-01-22 for EPIDURAL CATHETERIZATION KIT UR-05501-FR1 manufactured by Arrow International Inc..

Event Text Entries

[180316838] Qn#: (b)(4). The device has not been returned for investigation. Teleflex will continue to monitor and trend related events.
Patient Sequence No: 1, Text Type: N, H10


[180316839] It was reported that the green syringe from the kit for local anesthesia lacks resistance. It is impossible to inject with the syringe. Clinical consequences: a new syringe was used. Further information indicates that the issue is not a leak of the syringe, the incident is that the needle was not opened at its end. It was blocked.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3006425876-2020-00111
MDR Report Key9616686
Report SourceFOREIGN,HEALTH PROFESSIONAL,U
Date Received2020-01-22
Date of Report2020-01-17
Date of Event2020-01-15
Date Mfgr Received2020-03-05
Device Manufacturer Date2019-10-21
Date Added to Maude2020-01-22
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 ContactJASMINE BROWN
Manufacturer Street3015 CARRINGTON MILL BLVD
Manufacturer CityMORRISVILLE NC 27560
Manufacturer CountryUS
Manufacturer Postal27560
Manufacturer Phone9193614124
Manufacturer G1ARROW INTERNATIONAL CR, A.S.
Manufacturer StreetJAMSKA 2359/47
Manufacturer CityZDAR NAD SAZAVOU 591 01
Manufacturer CountryEZ
Manufacturer Postal Code591 01
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameEPIDURAL CATHETERIZATION KIT
Generic NameEPIDURAL ANESTHESIA KIT
Product CodeOGE
Date Received2020-01-22
Returned To Mfg2020-01-27
Catalog NumberUR-05501-FR1
Lot Number71F19K1689
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerARROW INTERNATIONAL INC.
Manufacturer AddressREADING PA


Patients

Patient NumberTreatmentOutcomeDate
10 2020-01-22

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