| Brand Name | MCKESSON BRANDS |
| Common Device Name | CATHETER, IV 24GX3/4" |
| Manufacturer (Section D) |
| SHINCHANG MEDICAL CO., LTD |
| #320 gongdan-dong gumi-shi |
| gyeongsangbuk-do, 730-0 30, |
| KS 730-030, |
|
| MDR Report Key | 23322805 |
| Report Number | 1451040-2025-00097 |
| Device Sequence Number | 21476038 |
| Product Code |
QOI
|
| UDI-Device Identifier | 10612479212593 |
| UDI-Public | 10612479212593 |
| Combination Product (Y/N) | N |
| Initial Reporter State | PA |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Importer
|
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
10/17/2025 |
| Report Date (Section F) |
10/17/2025 |
| 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
|
| Operator of Device |
Health Professional
|
| Device Catalogue Number | 6049 |
| Device Lot Number | KSN2413 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
Yes
|
| Distributor Facility Aware Date | 10/09/2025 |
| Device Age | 12 MO |
| Event Location |
Outpatient Treatment Facility
|
| Date Report to Manufacturer | 10/17/2025 |
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 10/17/2025 |
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
| Date Report Sent to FDA | 10/17/2025 |
|
|