FDA Adverse Event Injury Summary report: N

BARD TL CVC CATHETER

MDR report key: 15792916 · Received November 14, 2022

Report

Report Number
3006260740-2022-05170
Event Type
Injury
Date Received
November 14, 2022
Date of Event
November 22, 2021
Report Date
September 9, 2022
Manufacturer
C.R. BARD, INC. (BASD) -3006260740
Product Code
LJS
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BR
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 DURING CLINICAL ASSESSMENT. THERE IS REDNESS, SWELLING AND/OR FLUID DRAINAGE AT THE INSERTION SITE. THIS EVENT INVOLVED 1 TL CVC INSERTED SUBCLAVIAN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2767885 BARD TL CVC CATHETER CATHETER,INTRAVASCULAR,THERAPEUTIC,LONG-TERM GREATER THAN 30 DAYS LJS C.R. BARD, INC. (BASD) -3006260740 N/A UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention