BEUDAMED
    FDA Adverse Event Summary report: N

    MEDTRONIC COVIDIEN PICC

    MDR report key: 14086571 · Received April 1, 2022

    Report

    Report Number
    14086571
    Date Received
    April 1, 2022
    Date of Event
    March 16, 2022
    Report Date
    March 31, 2022
    Manufacturer
    MEDTRONIC
    Product Code
    LJS
    Report Source
    User Facility report
    Reporter Location
    TX, US
    Reporter Occupation
    RISK MANAGER
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    PICC CATHETER NOTED TO HAVE SLID THROUGH THE PURPLE BUTTERFLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    901570 MEDTRONIC COVIDIEN PICC ARGYLE PERIPHERAL INSERTED CENTRAL CATHETER LJS MEDTRONIC 1928200149

    Patients

    Seq Age Sex Outcome Treatment
    1 5 DA Male