FDA Adverse Event
Summary report: N
PER-Q-CATH PLUS DUAL-LUMEN MIDLINE WITH STYLET
MDR report key: 1830350
·
Received August 19, 2010
Report
- Report Number
- 1830350
- Date Received
- August 19, 2010
- Date of Event
- August 14, 2010
- Report Date
- August 19, 2010
- Manufacturer
- BARD ACCESS SYSTEMS INC.
- Product Code
- LJS
- Report Source
- User Facility report
- Reporter Location
- CA, US
- Reporter Occupation
- RISK MANAGER
Narratives
Description of Event or Problem · 1
THE DEVICE CAME APART AT THE HUB. THE CATHETER WAS STILL IN THE SITE AND REMOVED INTACT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PER-Q-CATH PLUS DUAL-LUMEN MIDLINE WITH STYLET | CATHETER, PICC, MIDLINE | LJS | BARD ACCESS SYSTEMS INC. | * | * |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 88 YR |