BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CENTRAL LINE

    MDR report key: 1800936 · Received August 10, 2010

    Report

    Report Number
    MW5017065
    Event Type
    Injury
    Date Received
    August 10, 2010
    Date of Event
    July 30, 2010
    Report Date
    August 3, 2010
    Manufacturer
    ARROW
    Product Code
    DQO
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    STAFF WERE PLACING A CENTRAL LINE. AN ANGIOCATH WAS THREADED OVER A GUIDE WIRE BUT WHEN THE GUIDEWIRE WAS WITHDRAWN, IT WAS NOTED TO BE UNRAVELED. CATH AND GUIDEWIRE WERE REMOVED COMPLETELY AND A NEW SITE FOR CVC WAS USED IN THE LT FEMORAL UNDER ULTRASOUND GUIDANCE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CENTRAL LINE DQO ARROW CF 9118606

    Patients

    Seq Age Sex Outcome Treatment
    1 25 YR Required Intervention