Brand Name | ARROW EPIDURAL CATHETERIZATION KIT |
Type of Device | ANESTHESIA CONDUCTION KIT |
Manufacturer (Section D) |
ARROW INTERNATIONAL INC. |
reading PA 19605 |
|
Manufacturer (Section G) |
ARROW INTERNATIONAL INC. |
312 commerce pl. |
|
asheboro NC |
|
Manufacturer Contact |
margie
burton, rn
|
po box 12600 |
durham, NC 27709
|
9194334965
|
|
MDR Report Key | 4074113 |
MDR Text Key | 21810303 |
Report Number | 1036844-2014-00271 |
Device Sequence Number | 1 |
Product Code |
CAZ
|
Combination Product (y/n) | N |
Reporter Country Code | JA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,User Facility,Company Representative |
Reporter Occupation |
Not Applicable
|
Type of Report
| Initial |
Report Date |
06/02/2014 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 06/23/2014 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Health Professional
|
Device Catalogue Number | ASK-05500-KM |
Device Lot Number | 23F13K0431 |
Was Device Available for Evaluation? |
Yes
|
Is the Reporter a Health Professional? |
No
|
Date Manufacturer Received | 06/02/2014 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 10/01/2013 |
Is the Device Single Use? |
Yes
|
Type of Device Usage |
Initial
|
Patient Sequence Number | 1 |