inforMED
MalfunctionMBP

DBP PUTTY 5CC

Received Jan 7, 2013

Report 2090010-2012-00015 · MDR key 2906910

Device

Generic name

Na

Catalog number

10-220-1050

Lot number

111876

Product problems

  • Device Contamination with Chemical or Other Material

Patient

Not reported

  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

IT WAS REPORTED THAT THE PRODUCT HAS BLACK PARTICLES IN IT. THE DEVICE WAS NOT IN CONTACT WITH THE PATIENT. THERE WAS NO PATIENT INJURY/DEATH. THE CLINICIAN REPORTED THE PRODUCT WAS STORED PER LABELED INSTRUCTIONS AND ALL THE SEALS WERE INTACT PRIOR TO ATTEMPTED USE.

Additional Manufacturer Narrative

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFORMATION.