FDA Adverse Event Other Summary report: N

NEOMEDICAL V-CATH PICC

MDR report key: 1730148 · Received June 11, 2010

Report

Report Number
2925153-2010-00007
Event Type
Other
Date Received
June 11, 2010
Report Date
June 11, 2010
Manufacturer
NEOMEDICAL
Product Code
DQY
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
EC
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT WAS ASSESSED AND DETERMINED TO BE A MDR REPORT BASED ON OUR MDR REPORTING CRITERIA. THE INFORMATION PROVIDED WITH THE REPORT IS SKETCHY. ADDITIONAL INFORMATION HAS BEEN REQUESTED BUT HAS NOT BEEN RECEIVED. AN EXAMINATION OF THE DEVICE(S) HAS NOT BEEN CARRIED OUT AS THE USED ITEM(S) WAS NOT RETURNED TO (B)(4).

Description of Event or Problem · 1

BASED ON THE REPORT INFORMATION, SUBMITTED TO (B)(4) ON (B)(6) 2010, PICCS LEAKED DURING USE. THE PRODUCT IS (B)(4). NO OTHER INFORMATION HAS BEEN MADE AVAILABLE. THE USED PRODUCTS / SAMPLES WERE NOT RETURNED TO (B)(4). (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEOMEDICAL V-CATH PICC V-CATH 2 FR PICC DQY NEOMEDICAL 355-72

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention