BEUDAMED
    FDA Adverse Event Other Summary report: N

    FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER

    MDR report key: 1193530 · Received October 8, 2008

    Report

    Report Number
    1710034-2008-00127
    Event Type
    Other
    Date Received
    October 8, 2008
    Date of Event
    August 28, 2008
    Report Date
    September 19, 2008
    Manufacturer
    BECTON DICKINSON INFUSION THERAPY SYSTEMS
    Product Code
    LJS
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE SAMPLE WAS RECEIVED ON 19 SEPTEMBER 2008 AND IS CURRENTLY BEING INVESTIGATED. UPON COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

    Description of Event or Problem · 1

    WHILE PERFORMING A ROUTINE PICC LINE DRESSING CHANGE IN ASEPTIC TECHNIQUE, THE CATHETER BROKE.

    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