BEUDAMED
    FDA Adverse Event Other Summary report: N

    HICKMAN

    MDR report key: 121621 · Received July 3, 1997

    Report

    Report Number
    MW1012133
    Event Type
    Other
    Date Received
    July 3, 1997
    Date of Event
    June 27, 1997
    Report Date
    June 27, 1997
    Manufacturer
    BARD ACCESS SYSTEMS, INC.
    Product Code
    DQO
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    RPTR RECEIVED PHONE CALL FROM ER STATING THE PT PRESENTED IN THE ER AT 5 AM WITH A BROKEN HICKMAN CATH. THE CATH WAS REPAIRED, BUT IT SHOULD REMAIN UNUSED FOR 24 HRS. ER STARTED A PIV AND RECONNECTED PT'S CURRENT BAG OF PRIMACOR. ER INSTRUCTED THE PT TO CALL RPTR FOR ANY FURTHER PROBLEMS. RPTR WILL SCHEDULE AN SN TO VISIT PT 6/28 AM TO DC PIV AND RESTART PRIMACOR USING THE HICKMAN CATH. CALLED PT AT HOME TO FOLLOW-UP. PT STATED THE PRIMACOR WAS INFUSING WITHOUT PROBLEMS. PT WILL PERFORM THE BAG CHANGE TONIGHT USING THE SAME TECHNIQUE. RPTR INFORMED PT TO CALL IF THEY HAVE ANY QUESTIONS. RPTR INFORMED PT, A NURSE WILL VISIT SAT. AM TO DC PIV, ASSESS HICKMAN, AND CONNECT PRIMACOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HICKMAN DOUBLE LUMEN CATHETER DQO BARD ACCESS SYSTEMS, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Other