BEUDAMED
    FDA Adverse Event Other Summary report: N

    ARROW GARD

    MDR report key: 136396 · Received November 28, 1997

    Report

    Report Number
    MW1012602
    Event Type
    Other
    Date Received
    November 28, 1997
    Manufacturer
    ARROW INTERNATIONAL, INC.
    Product Code
    DQO
    Report Source
    Voluntary report
    Reporter Location
    AR, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT & HUSBAND STATES THE PORTS ON TRIPLE LUMEN "KEPT COMING APART". "CAPS JUST KEEP COMING OFF".

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ARROW GARD Implant TRIPLE LUMEN CATHETER DQO ARROW INTERNATIONAL, INC. CS-24703-E UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 38 YR Other