BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SECURACATH

    MDR report key: 15612092 · Received October 14, 2022

    Report

    Report Number
    15612092
    Event Type
    Malfunction
    Date Received
    October 14, 2022
    Date of Event
    June 13, 2022
    Report Date
    September 27, 2022
    Manufacturer
    INTERRAD MEDICAL, INC.
    Product Code
    KMK
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    SECURACATH USED INCORRECTLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2820407 SECURACATH DEVICE, INTRAVASCULAR CATHETER SECUREMENT KMK INTERRAD MEDICAL, INC. 5F A5022

    Patients

    Seq Age Sex Outcome Treatment
    1 28105 DA Female Other