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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PAJUNK GMBH MEDIZINTECHNOLOGIE PLEXOLONG NANOLINE MEIER PERIPHERAL NERVE BLOCK KIT

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PAJUNK GMBH MEDIZINTECHNOLOGIE PLEXOLONG NANOLINE MEIER PERIPHERAL NERVE BLOCK KIT Back to Search Results
Model Number 531156-31A
Device Problems Nonstandard Device (1420); Product Quality Problem (1506); Device-Device Incompatibility (2919); Positioning Problem (3009)
Patient Problems Awareness during Anaesthesia (1707); No Known Impact Or Consequence To Patient (2692)
Event Date 02/01/2016
Event Type  malfunction  
Manufacturer Narrative
Event took place in (b)(6). Device has not yet been sent back for evaluation. As soon as further information or device evaluation becomes available, a fu report will be sent to the agency. Not yet returned.
 
Event Description
Internal report number: (b)(4). User's narrative: unable to advance catheter through needle.
 
Manufacturer Narrative
Event took place in (b)(6). Based on risk assessment and clinical evaluation file is considered as closed.
 
Event Description
(b)(4). User's narrative: unable to advance catheter through needle.
 
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Brand NamePLEXOLONG NANOLINE MEIER
Type of DevicePERIPHERAL NERVE BLOCK KIT
Manufacturer (Section D)
PAJUNK GMBH MEDIZINTECHNOLOGIE
karl-hall-str. 1
geisingen, baden-wuerttemberg 78187
GM 78187
Manufacturer (Section G)
PAJUNK GMBH MEDIZINTECHNOLOGIE
karl-hall-str. 1
geisingen, baden-wuerttemberg 78187
GM 78187
Manufacturer Contact
christian quass
karl-hall-str. 1
regulatory & safety affairs
geisingen, baden-wuerttemberg 78187
GM   78187
7704929158
MDR Report Key5483185
MDR Text Key40059931
Report Number9611612-2016-00027
Device Sequence Number1
Product Code CAZ
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
K053283
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,distri
Reporter Occupation
Type of Report Initial,Followup
Report Date 06/15/2016
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/07/2016
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator
Device Model Number531156-31A
Device Catalogue Number531156-31A
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/24/2016
Is the Reporter a Health Professional? No
Was the Report Sent to FDA?
Event Location No Information
Date Manufacturer Received02/22/2016
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial

Patient Treatment Data
Date Received: 03/07/2016 Patient Sequence Number: 1
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