BEUDAMED
    FDA Adverse Event Other Summary report: N

    V-CATH

    MDR report key: 2026229 · Received March 14, 2011

    Report

    Report Number
    2925153-2011-00005
    Event Type
    Other
    Date Received
    March 14, 2011
    Date of Event
    January 25, 2011
    Report Date
    March 9, 2011
    Manufacturer
    NEO MEDICAL, INC.
    Product Code
    DQY
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    AS NOTED ON INTERNAL REPORT# (B)(4) FROM (B)(4) HOSP, FAXED TO NEO MEDICAL ON (B)(6) 2011 FROM MEDSPEC, INC. (DISTRIBUTOR): PICC LINE DISCONNECTED AT CATHETER SITE AND HUB, LINE WAS DC'D. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH V-CATH 3.9FR 320CM DLL PICC DQY NEO MEDICAL, INC. 3929-2630

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention