FDA Adverse Event Malfunction Summary report: N

NIPRO SAFELET CATH

MDR report key: 20050503 · Received August 23, 2024

Report

Report Number
9610987-2024-00006
Event Type
Malfunction
Date Received
August 23, 2024
Date of Event
July 10, 2024
Report Date
August 29, 2024
Manufacturer
NIPRO CORPORATION (ODT)
Product Code
FOZ
PMA / PMN Number
K960051
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PICTURE OF ACTUAL USED SAMPLE ATTACHED.

Description of Event or Problem · 0

THE PINPOINT OF IV CATH IS BROKEN IN PUNCTURE OPERATION. THE RESISTANCE OF CATH IS HARDER WHEN PUNCTURING, SO REPEATED PUNCTURE OPERATIONS EXISTED SOMETIMES, AND PINPOINT OF CATH (TIP OF OUTER CATHETER) WAS FOUND BROKEN AFTER WITHDRAWAL. NO PATIENT INJURY OR MEDICAL INTERVENTION. NO ADDITIONAL INFORMATINO PROVIDED.

Description of Event or Problem · 0

THE PINPOINT OF IV CATH IS BROKEN IN PUNCTURE OPERATION. THE RESISTANCE OF CATH IS HARDER WHEN PUNCTURING, SO REPEATED PUNCTURE OPERATIONS EXISTED SOMETIMES, AND PINPOINT OF CATH (TIP OF OUTER CATHETER) WAS FOUND BROKEN AFTER WITHDRAWAL. NO PATIENT INJURY OR MEDICAL INTERVENTION. NO ADDITIONAL INFORMATINO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1743061 NIPRO SAFELET CATH IV CATHETER FOZ NIPRO CORPORATION (ODT) NIC-22G (1") 24A18C

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other