| Brand Name | SAFE-T-CENTESIS KIT 8FR X 16CM |
| Common Device Name | thoracentesis tray |
| 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
|
|
+1(801)565-2341
|
|
| MDR Report Key | 50744975 |
| Report Number | 1423507-2026-00271 |
| Device Sequence Number | 10166476 |
| Product Code |
PXI
|
| UDI-Device Identifier | 10885403076107 |
| UDI-Public | (01)10885403076107(17)300429(10)0001624230 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | AS |
| PMA/510(K) Number | NA |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/12/2026 |
| 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 | PIG1280K |
| Device Lot Number | 0001624230 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 08/21/2026 |
| Initial Report FDA Received Date | 09/12/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 05/30/2025 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |