FDA Adverse Event Other Summary report: N

FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER

MDR report key: 1356391 · Received April 2, 2009

Report

Report Number
1710034-2009-00054
Event Type
Other
Date Received
April 2, 2009
Date of Event
February 12, 2009
Report Date
March 3, 2009
Manufacturer
BECTON DICKINSON INFUSION THERAPY SYSTEMS
Product Code
FOZ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE SAMPLE WAS RECEIVED ON 03/23/2009 AND IS CURRENTLY BEING DECONTAMINATED. UPON DECONTAMINATION AND COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. (B)(4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT 5 DAYS AFTER INSERTION OF THE CATHETER, OBSERVED SKIN IRRITATION AND HYPEREMIA. THE CATHETER WAS REMOVED ON (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER PERCUTANEOUS CATHETER FOZ BECTON DICKINSON INFUSION THERAPY SYSTEMS NA 8092977

Patients

Seq Age Sex Outcome Treatment
1 31 DA Other ALCOHOLIC CHLOROHEX