BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COOK CENTRAL VENOUS CATHETER KIT GUIDE WIRE 7-FRENCH, TRIPLE LUMEN, ANTIBIOTIC I

    MDR report key: 2072699 · Received April 25, 2011

    Report

    Report Number
    MW5020406
    Event Type
    Injury
    Date Received
    April 25, 2011
    Date of Event
    March 28, 2011
    Report Date
    April 21, 2011
    Manufacturer
    COOK MEDICAL
    Product Code
    DQX
    Report Source
    Voluntary report
    Reporter Location
    DE, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    GUIDE WIRE FOUND IN PLACE WHEN TRIPLE LUMEN FEMORAL LINE REMOVED. GUIDE WIRE REMOVED WITHOUT INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COOK CENTRAL VENOUS CATHETER KIT GUIDE WIRE 7-FRENCH, TRIPLE LUMEN, ANTIBIOTIC I CENTRAL LINE GUIDE WIRE DQX COOK MEDICAL 2653320

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Required Intervention