FDA Adverse Event
Other
Summary report: N
FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER
MDR report key: 1003828
·
Received February 26, 2008
Report
- Report Number
- 1710034-2008-00026
- Event Type
- Other
- Date Received
- February 26, 2008
- Report Date
- February 18, 2008
- Manufacturer
- BECTON DICKINSON INFUSION THERAPY SYSTEMS
- Product Code
- LJS
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SC, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
SENT A PREPAID MAILING TUBE AND LABEL TO CUSTOMER FOR THE RETURN OF THE SAMPLE. ADDITIONAL INFORMATION HAS BEEN REQUESTED. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.
Description of Event or Problem · 1
PEDIATRIC PICC CATHETER BROKE AT THE STRAIN RELIEF IN TWO PIECES.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER | PERCUTANEOUS CATHETER | LJS | BECTON DICKINSON INFUSION THERAPY SYSTEMS | NA | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK | Other |