MAUDE MDR 9672058

MDR report key
9672058
Report number
1036844-2020-00056
Event key
0
Event type
3
Date of event
2019-08-22
Date received
2020-02-05
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
500
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
JASMINE BROWN
Address
3015 CARRINGTON MILL BLVD MORRISVILLE NC 27560 US
Phone
919-919-9193
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1SPINAL ANESTHESIA KITNEEDLE, CONDUCTION, ANESTHETICARROW INTERNATIONAL INC.BSPASA-24103-SB23F18L0326R N

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-02-050

Event Narratives#

N

Patient 1

(B)(4). THE DEVICE HAS NOT BEEN RETURNED FOR INVESTIGATION. TELEFLEX WILL CONTINUE TO MONITOR AND TREND RELATED EVENTS.

D

Patient 1

IT WAS REPORTED THAT THERE WAS A BROKEN BUPIVACAINE VIAL.