BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MAHURKAR DIALYSIS CATHETER

    MDR report key: 12106 · Received March 18, 1994

    Report

    Report Number
    MW1001140
    Event Type
    Malfunction
    Date Received
    March 18, 1994
    Date of Event
    March 15, 1994
    Report Date
    March 17, 1994
    Manufacturer
    QUINTON INSTRUMENT CO.
    Product Code
    LFJ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    THE SUTURE CLIP TORE ON BOTH SIDES OF THE CATHETER AND THE CATHETER FELL OUT. THE INCIDENT OCCURRED FOUR HRS AFTER INSERTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MAHURKAR DIALYSIS CATHETER LFJ QUINTON INSTRUMENT CO. 860138

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR