Brand Name | NDLE, TWOFER, 16GX 1.5, HUBR,G |
Type of Device | SET, I.V. FLUID TRANSFER |
Manufacturer (Section D) |
BAXTER HEALTHCARE - ENGLEWOOD |
englewood CO |
|
Manufacturer (Section G) |
BAXTER HEALTHCARE - ENGLEWOOD |
14445 grasslands dr |
|
englewood CO 80112 |
|
Manufacturer Contact |
|
25212 w. illinois route 120 |
round lake, IL 60073
|
2242702068
|
|
MDR Report Key | 6906948 |
MDR Text Key | 87886088 |
Report Number | 1416980-2017-07950 |
Device Sequence Number | 1 |
Product Code |
LHI
|
Combination Product (y/n) | N |
Reporter Country Code | NO |
PMA/PMN Number | K832347 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
company representative,foreig |
Reporter Occupation |
Other
|
Type of Report
| Initial,Followup |
Report Date |
10/24/2017 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 10/02/2017 |
Is this an Adverse Event Report? |
No
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Other
|
Device Catalogue Number | H93819003 |
Device Lot Number | 1193629 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
No
|
Date Manufacturer Received | 10/19/2017 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
N
|
Patient Sequence Number | 1 |
|
|