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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL INC. SPINAL ANES/EPIDURAL CATH KIT; CATHETER, CONDUCTION, ANESTHET

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ARROW INTERNATIONAL INC. SPINAL ANES/EPIDURAL CATH KIT; CATHETER, CONDUCTION, ANESTHET Back to Search Results
Catalog Number ASK-05500-BID
Device Problems Break (1069); Packaging Problem (3007)
Patient Problem No Patient Involvement (2645)
Event Date 05/22/2019
Event Type  malfunction  
Manufacturer Narrative
(b)(4).The device has not been returned for investigation.Teleflex will continue to monitor and trend related events.
 
Event Description
It was reported that when they opened the kits the vials were broken, in addition the supplies do not seem to be staying where they are supposed to.Please work on packaging.
 
Manufacturer Narrative
(b)(4).A lot number was not provided.A device history record review was performed based upon a lot number from sales history data.A device history record review was performed with a potentially relevant finding.A nonconformance was initiated only as a general nc to temporarily allow certain finished good part numbers to be packaged with additional gauze in order to better secure medication ampules in the inner tray.Complaint verification testing could not be performed as no sample was returned for analysis.A lot number was not provided.A device history record review was performed based upon a lot number from sales history data.A device history record review was performed with a potentially relevant finding.Based on the information provided, the potential root cause of this issue is design related.A capa was initiated to further investigate this complaint issue.
 
Event Description
It was reported that when they opened the kits the vials were broken, in addition the supplies do not seem to be staying where they are supposed to.Please work on packaging.
 
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Brand Name
SPINAL ANES/EPIDURAL CATH KIT
Type of Device
CATHETER, CONDUCTION, ANESTHET
Manufacturer (Section D)
ARROW INTERNATIONAL INC.
reading PA
MDR Report Key8709140
MDR Text Key148337643
Report Number1036844-2019-00683
Device Sequence Number1
Product Code BSO
Combination Product (y/n)N
PMA/PMN Number
K140110
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Type of Report Initial,Followup
Report Date 05/22/2019
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 Catalogue NumberASK-05500-BID
Device Lot NumberUNKNOW
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 05/22/2019
Initial Date FDA Received06/18/2019
Supplement Dates Manufacturer Received07/05/2019
Supplement Dates FDA Received07/08/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Treatment
N/A.
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