FDA Adverse Event Summary report: N

L-CATH PICC

MDR report key: 1981790 · Received January 19, 2011

Report

Report Number
1625425-2011-00006
Date Received
January 19, 2011
Date of Event
December 10, 2010
Report Date
December 20, 2010
Manufacturer
ARGON MEDICAL DEVICES INC.
Product Code
LJS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

RESULTS OF INVESTIGATION WILL BE PROVIDED IN A SUPPLEMENTAL REPORT ONCE COMPLETE.

Description of Event or Problem · 1

CATHETER WAS IMPLEMENTED WITH RADIOLOGICAL VERIFICATION OF THE CATHETER PLACEMENT. COMPLICATION OCCURRED 24 HOURS AFTER INSERTION. (PERFUSO-THORAX).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 L-CATH PICC L-CATH LJS ARGON MEDICAL DEVICES INC. NA 0005199

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention