Brand Name | BD VACUTAINER® ULTRATOUCH¿ PUSH BUTTON |
Type of Device | BLOOD COLLECTION/INTRAVENOUS FLUID ADMINISTRATION SET |
Manufacturer (Section D) |
BECTON, DICKINSON & CO., (BD) |
1575 airport road |
sumter SC 29153 |
|
Manufacturer (Section G) |
BECTON, DICKINSON & CO., (BD) |
1575 airport road |
|
sumter SC 29153 |
|
Manufacturer Contact |
brett
wilko
|
9450 south state street |
sandy, UT 84070
|
8015652845
|
|
MDR Report Key | 8216482 |
MDR Text Key | 132078409 |
Report Number | 1024879-2018-01575 |
Device Sequence Number | 1 |
Product Code |
FPA
|
Combination Product (y/n) | N |
Reporter Country Code | CA |
PMA/PMN Number | K153309 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
foreign,other,user facility |
Reporter Occupation |
Other Health Care Professional
|
Type of Report
| Initial,Followup,Followup |
Report Date |
03/04/2019 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Date FDA Received | 01/04/2019 |
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
Yes
|
Device Operator |
Other
|
Device Expiration Date | 06/30/2020 |
Device Catalogue Number | 367365 |
Device Lot Number | 8176608 |
Was Device Available for Evaluation? |
No Answer Provided
|
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
|
Event Location |
No Information
|
Date Manufacturer Received | 12/17/2018 |
Was Device Evaluated by Manufacturer? |
Device Not Returned to Manufacturer
|
Date Device Manufactured | 06/25/2018 |
Is the Device Single Use? |
Yes
|
Is This a Reprocessed and Reused Single-Use Device? |
No
|
Type of Device Usage |
Initial
|