ARGYLE 8888301622

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2017-06-29 for ARGYLE 8888301622 manufactured by Covidien.

Event Text Entries

[78695357] Submit date: 6/29/17. An investigation is currently under way; upon completion the results will be forwarded.
Patient Sequence No: 1, Text Type: N, H10


[78695358] The customer reports tip of suction tubing coming off. Molded connector is not attached to tubing.
Patient Sequence No: 1, Text Type: D, B5


[113285669] One unused samples with lot number 710018364x was received for evaluation. After performing a visual inspection the issue was observed; the inner packaging contains a broken component. The dhr file was reviewed indicating that product was released meeting all quality standard requirements. A probable root cause of this condition is attributed to a failure in the solvent presence sensors of the extruder machine where the tube is cut to length then the tips are inserted into the tubing using this solvent. The following corrective action was established: product specification has been updated to include a checklist for inspection of the machine sensors to ensure they are in good working condition to minimize the reoccurrence of the reported condition. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9612030-2017-05120
MDR Report Key6676825
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2017-06-29
Date of Report2018-01-09
Date of Event2017-06-06
Date Mfgr Received2017-06-06
Device Manufacturer Date2017-03-11
Date Added to Maude2017-06-29
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactEDWARD ALMEIDA
Manufacturer Street15 HAMPSHIRE STREET
Manufacturer CityMANSFIELD MA 02048
Manufacturer CountryUS
Manufacturer Postal02048
Manufacturer Phone5084524151
Manufacturer G1COVIDIEN
Manufacturer StreetCALLE 9 SUR NO. 125 CUIDAD
Manufacturer CityTIJUANA,NA 92173
Manufacturer CountryMX
Manufacturer Postal Code92173
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameARGYLE
Generic NameTUBING, NONINVASIVE
Product CodeGAZ
Date Received2017-06-29
Model Number8888301622
Catalog Number8888301622
Lot Number705916564X
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerCOVIDIEN
Manufacturer AddressCALLE 9 SUR NO. 125 CUIDAD TIJUANA,NA 92173 MX 92173


Patients

Patient NumberTreatmentOutcomeDate
10 2017-06-29

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