BEUDAMED
    FDA Adverse Event Injury Summary report: N

    KIT CATH MTLUM PRES INJ CVC LF

    MDR report key: 10000580 · Received April 24, 2020

    Report

    Report Number
    MW5094264
    Event Type
    Injury
    Date Received
    April 24, 2020
    Date of Event
    April 10, 2020
    Report Date
    April 22, 2020
    Manufacturer
    TELEFLEX LLC / / ARROW INTERNATIONAL LLC
    Product Code
    DQY
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    PART OF A CENTRAL LINE GUIDE WIRE WAS RETAINED IN THE PATIENT POST CENTRAL LINE PLACEMENT. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    462375 KIT CATH MTLUM PRES INJ CVC LF CATHETER, PERCUTANEOUS DQY TELEFLEX LLC / / ARROW INTERNATIONAL LLC CDC-45703-XP1A

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Required Intervention