Brand Name | BD INSYTE VIALON-E IV CATHETER |
Type of Device | INTRAVASCULAR CATHETER |
Manufacturer (Section D) |
BECTON DICKINSON MEDICAL (SINGAPORE) |
30 tuas avenue 2 |
singapore |
|
Manufacturer (Section G) |
BECTON DICKINSON MEDICAL (SINGAPORE) |
30 tuas avenue 2 |
|
singapore |
|
Manufacturer Contact |
brett
wilko
|
9450 south state street |
sandy, UT 84070
|
8015296192
|
|
MDR Report Key | 10793149 |
MDR Text Key | 216414668 |
Report Number | 8041187-2020-00712 |
Device Sequence Number | 1 |
Product Code |
FOZ
|
Combination Product (y/n) | N |
Reporter Country Code | JA |
PMA/PMN Number | NA |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign,other,user facility |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup |
Report Date |
12/22/2020 |
1 Device was Involved in the Event |
|
0 Patients were Involved in the Event: |
|
Date FDA Received | 11/05/2020 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Other
|
Device Catalogue Number | 388434 |
Device Lot Number | 9024657 |
Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
Date Returned to Manufacturer | 10/22/2020 |
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
|
Event Location |
No Information
|
Date Manufacturer Received | 12/22/2020 |
Was Device Evaluated by Manufacturer? |
Yes
|
Date Device Manufactured | 01/24/2019 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|