inforMED
MalfunctionEXG

ESTEEM+

Received Jun 26, 2023

Report 1049092-2023-00208 · MDR key 17196971

Device

Generic name

Bag, Urine Collecting, Ureterostomy

Manufacturer

Convatec Inc

Model number

422545

Lot number

0000737544

Product problems

  • Malposition of Device
  • Malposition of Device

Patient

Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Description of Event or Problem

IT WAS REPORTED BY THE RETAILER THAT WAFER HAD OFF CENTERED STARTED HOLE. THE PRODUCT WAS NOT USED BY PATIENT. NO PHOTO IS AVAILABLE AT THIS TIME.

Additional Manufacturer Narrative

DEVICE 2 OF 3. E1: COMPLAINANT STATE: (B)(6). COMPLAINANT COUNTRY: (B)(6). NAME OF AFFILIATION: (B)(6). BASED ON THE AVAILABLE INFORMATION, THIS EVENT IS DEEMED TO BE A REPORTABLE MALFUNCTION . TO DATE NO ADDITIONAL INFORMATION HAS BEEN RECEIVED. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, A FOLLOW-UP REPORT WILL BE SUBMITTED. FDA REGISTRATION NUMBER REPORTING SITE: 1049092. THIRD PARTY MANUFACTURING SITE (FOR LIFE): 3003759552.