FDA Adverse Event Malfunction Summary report: N

BARD TL DIALYSIS CATHETER

MDR report key: 15781479 · Received November 11, 2022

Report

Report Number
3006260740-2022-05028
Event Type
Malfunction
Date Received
November 11, 2022
Date of Event
May 11, 2021
Report Date
October 21, 2022
Manufacturer
C.R. BARD, INC. (BASD) -3006260740
Product Code
MPB
PMA / PMN Number
UNK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE DATE OF EVENT WAS NOT PROVIDED BY THE COMPLAINANT/REPORTER, THE DATE REFLECTED IN THIS REPORT IS THE DATE BD BECAME AWARE OF THE EVENT. THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER FOR EVALUATION. A LOT HISTORY REVIEW (LHR) REVIEW IS NOT POSSIBLE, AS NO MANUFACTURING LOT NUMBER HAS BEEN PROVIDED BY THE COMPLAINANT.

Description of Event or Problem · 0

IT WAS REPORTED "THE FOLLOWING WAS OBTAINED DURING CLINICAL ASSESSMENT. FLUID LEAKING FROM CENTRAL LINE INSERTION SITE." THE EVENT INVOLVED 1 TL DIALYSIS INSERTED FEMORALLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2689141 BARD TL DIALYSIS CATHETER CATHETER, HEMODIALYSIS, NON-IMPLANTED MPB C.R. BARD, INC. (BASD) -3006260740 N/A UNK

Patients

Seq Age Sex Outcome Treatment
1 Unknown Other