InjuryBTC

CADD MEDICATION CASSETTE RESERVOIR

Received Feb 21, 2007 · Event occurred Feb 1, 2007

Report 2183502-2007-00029 · MDR key 820650

Device

Generic name

Medication Reservoir

Manufacturer

Smiths Medical Md

Model number

21-7002

Catalog number

21-7002

Lot number

UNK

Product problems

Unknown (for use when the device problem is not known)

Patient

55 YR

Occlusion
Surgical procedure, additional

Narrative

Additional Manufacturer Narrative

ADDITIONAL MANUFACTURER NARRATIVE: CUSTOMER HAS NOT YET RETURNED THE DEVICE TO THE MANUFACTURER FOR DEVICE EVALUATION. WHEN AND IF THE DEVICE BECOMES AVAILABLE AND IS RETURNED AND EVALUATED THE MANUFACTURER WILL FILE A FOLLOW-UP REPORT DETAILING THE RESULTS OF THE EVALUATION.

Description of Event or Problem

THE MANUFACTURER HAS BECOME AWARE VIA INFO RECEIVED FROM THE INITIAL REPORTER REGARDING AN ALLEGED INCIDENT OF A CLOGGED CATHETER (MANUFACTURER AND MODEL UNIDENTIFIED) THAT REQUIRED INTERVENTION AND POSSIBLE SUBSEQUENT REMOVAL/REPLACEMENT.