FDA Adverse Event
Injury
Summary report: N
GROSHONG NXT CLEARVUE 4 FR SL PICC NURSING FULL TRAY
MDR report key: 1812335
·
Received August 17, 2010
Report
- Report Number
- 3006260740-2010-00247
- Event Type
- Injury
- Date Received
- August 17, 2010
- Date of Event
- March 14, 2010
- Report Date
- August 11, 2010
- Manufacturer
- C. R. BARD INC. (BASD)
- Product Code
- LJS
- PMA / PMN Number
- K034020
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SW
- Reporter Occupation
- NURSE
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER FOR EVALUATION. A CHR REVIEW SHOWED NO OTHER SIMILAR PRODUCT COMPLAINT FILE(S) FROM THIS LOT.
Description of Event or Problem · 1
THE CATHETER WAS FOUND IN ARTERIA PULMONARIS. PATIENT IS OK NOW AFTER REMOVAL OF THE CATHETER.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | GROSHONG NXT CLEARVUE 4 FR SL PICC NURSING FULL TRAY | LJS | C. R. BARD INC. (BASD) | NA | RETF0819 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |