| Brand Name | PLEURX DRAINAGE KIT 1000ML |
| Common Device Name | Apparatus, Suction, Patient Care |
| Manufacturer (Section D) |
| CAREFUSION, INC |
| 75 n. fairview drive |
| vernon hills IL 60061 |
|
| Manufacturer (Section G) |
| CareFusion, Inc |
| zona franca las americas |
|
| santo domingo |
|
| Manufacturer Contact |
|
michael
gaffney
|
| 75 n. fairview drive |
| vernon hills, IL 60061
|
|
8015652341
|
|
| MDR Report Key | 25881806 |
| Report Number | 1423507-2026-00105 |
| Device Sequence Number | 8103788 |
| Product Code |
DWM
|
| UDI-Device Identifier | 10885403090707 |
| UDI-Public | (01)10885403090707(17)271024(10)0001621716 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | GM |
| PMA/510(K) Number | SEE H.11. |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2024 |
| Reporter Type |
Manufacturer
|
| Report Source |
Distributor |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
08/24/2026 |
| 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 | 50-7510 |
| Device Lot Number | 0001621716 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/24/2026 |
| Supplement Date Received by Manufacturer | 08/24/2026
|
| Initial Report FDA Received Date | 07/20/2026 |
| Supplement Report FDA Received Date | 08/25/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 05/07/2025 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |