Brand Name | CARTRIDGE DISPOSABLE 3IN EXT SET STERILE |
Type of Device | WARMER, THERMAL, INFUSION FLUID |
Manufacturer (Section D) |
CAREFUSION |
75 north fairway drive |
vernon hills IL 60061 |
|
Manufacturer (Section G) |
HEALTHCARE TECHNOLOGY INTL LTD |
yin yang industrial estate, zh |
|
dongguan, guangdong 53262 0 |
CH
532620
|
|
Manufacturer Contact |
jill
rittorno
|
75 north fairway drive |
vernon hills, IL 60061
|
8473628056
|
|
MDR Report Key | 4681258 |
MDR Text Key | 5622552 |
Report Number | 2242551-2015-00023 |
Device Sequence Number | 1 |
Product Code |
LGZ
|
Combination Product (y/n) | N |
Reporter Country Code | NL |
PMA/PMN Number | K130867 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Foreign,Health Professional,User Facility,Company Representative,company represent |
Reporter Occupation |
Nurse
|
Type of Report
| Initial,Followup |
Report Date |
12/20/2016 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Other Health Care Professional
|
Device Model Number | 980202EU |
Device Lot Number | UNKNOWN |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Initial Date Manufacturer Received |
02/06/2015 |
Initial Date FDA Received | 04/10/2015 |
Supplement Dates Manufacturer Received | Not provided
|
Supplement Dates FDA Received | 12/20/2016
|
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
No
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Unknown
|
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
|
|
|