BEUDAMED
    FDA Adverse Event Injury Summary report: N

    V-CATH

    MDR report key: 13749 · Received June 2, 1994

    Report

    Report Number
    MW1002337
    Event Type
    Injury
    Date Received
    June 2, 1994
    Report Date
    May 6, 1994
    Manufacturer
    HDC CORP.
    Product Code
    DQO
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PICC CATHETER WAS INSERTED, RN HAD DIFFICULTY PULLING BACK ON GUIDE WIRE TO TRIM CATHETER AND GUIDE WIRE WAS REMOVED BEFORE INSERTION. WHEN PICC LINE WAS TO BE PULLED, RN HAD DIFFICULTY REMOVING. ALL APPROPRIATE INTERVENTIONS WERE TAKEN PER MFR'S INSTRUCTION FOR STUCK CATHETER. ON LAST ATTEMPT TO REMOVE, PICC LINE SNAPPED AND BROKE. RN WAS UNABLE TO RETRIEVE PORTION IN PT'S ARM. TOURNIQUET WAS PLACED. PT TAKEN TO ER. SURGERY WAS NECESSARY TO REMOVE INDWELLING CATHETER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH PERIPHERALLY INSERTED CENTRAL LINE DQO HDC CORP. 360-40 056

    Patients

    Seq Age Sex Outcome Treatment
    1 56 YR Hospitalization| R