Brand Name | ARROW HEMODIALYSIS SET: 2-L 15 FR X 27 CM RETR |
Type of Device | CATHETER, HEMODIALYSIS, IMPLA |
Manufacturer (Section D) |
ARROW INTERNATIONAL LLC |
morrisville NC |
|
Manufacturer (Section G) |
ARROW INTERNATIONAL DE MEXICO S.A. DE C.V. |
ave. washington 3701 |
colonia panamericana, chihuahua |
chihuahua 31200 |
MX
31200
|
|
Manufacturer Contact |
katharine
tarpley
|
3015 carrington mill blvd |
morrisville, NC 27560
|
|
MDR Report Key | 18501014 |
MDR Text Key | 332724192 |
Report Number | 9680794-2024-00056 |
Device Sequence Number | 1 |
Product Code |
MSD
|
UDI-Device Identifier | 10801902127355 |
UDI-Public | 10801902127355 |
Combination Product (y/n) | N |
Reporter Country Code | IT |
PMA/PMN Number | K141051 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,User Facility,Company Representative |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Model Number | IPN920486 |
Device Catalogue Number | CS-15272-VFE |
Device Lot Number | 13F22K0254 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
No
|
Initial Date Manufacturer Received |
Not provided
|
Initial Date FDA Received | 01/12/2024 |
Supplement Dates Manufacturer Received | 02/06/2024
|
Supplement Dates FDA Received | 02/07/2024
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 11/29/2022 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |
Treatment | NOT REPORTED; NOT REPORTED |