FDA Adverse Event Malfunction Summary report: N

POWERPICC SOLO CATHETER WITH SHERLOCK 3CG TPS

MDR report key: 20759278 · Received November 22, 2024

Report

Report Number
3006260740-2024-06914
Event Type
Malfunction
Date Received
November 22, 2024
Date of Event
October 29, 2024
Report Date
May 23, 2025
Manufacturer
C.R. BARD, INC. (BASD) -3006260740
Product Code
LJS
UDI-DI
00801741138973
PMA / PMN Number
K091324
Removal / Correction Number
MDS-24-5154-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SW
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H11: SECTION A THROUGH F - THE INFORMATION PROVIDED BY BD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BD. THE MANUFACTURER HAS RECEIVED THE SAMPLE AND IT WILL BE EVALUATED. A SUPPLEMENTAL WILL BE SUBMITTED WITH EVALUATION RESULTS.

Additional Manufacturer Narrative · 0

H11: SECTION A THROUGH F - THE INFORMATION PROVIDED BY BD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BD. THE COMPLAINT OF A LEAK WAS CONFIRMED. THE PRODUCT RETURNED FOR EVALUATION WAS ONE 4 FR SL POWERPICC SOLO CATHETER. THE INVESTIGATION FINDINGS ARE CONSISTENT WITH DAMAGE ACCUMULATED THROUGH FLEXURAL FATIGUE. FLEXURAL FATIGUE OCCURS DUE TO CYCLIC KINKING OF THE CATHETER TUBE IN WHICH PHYSIOLOGICAL, PLACEMENT, USAGE, AND MECHANICAL FACTORS MAY GRADUALLY FORM A CRACK(S) IN THE CATHETER. THE RETURNED PRODUCT SAMPLE WAS EVALUATED AND A SPLIT WAS OBSERVED IN THE CATHETER TUBING BETWEEN THE 4 CM AND 5 CM DEPTH MARKERS. THE CATHETER SPLIT CONTAINED PHYSICAL FEATURES ASSOCIATED WITH MATERIAL FATIGUE, AND THE CHARACTERISTICS OBSERVED WHICH SUPPORTED THIS TYPE OF FAILURE INCLUDED: DAMAGE WHICH WAS CIRCUMFERENTIALLY ALIGNED. FRACTURE EDGES WHICH WERE ROUNDED AND POLISHED DUE TO REPEATED MATERIAL WEAR. 'C' SHAPED IMPRESSIONS LEADING INTO THE FRACTURE SITE WHICH ARE CONSISTENT WITH MATERIAL BUCKLING DUE TO MOVEMENT WHICH CAUSED THE FRACTURE EDGES TO BE PRESSED TOGETHER. REPETITIVE KINKING OF THE INDWELLING CATHETER APPEARS TO HAVE CONTRIBUTED TO THE OBSERVED SPLIT; HOWEVER, THE SPECIFIC CIRCUMSTANCES SURROUNDING HOW KINKING DEVELOPED INTO A FRACTURE WITHIN THE CATHETER TUBING WERE ULTIMATELY UNKNOWN. A MEASUREMENT OF THE CATHETER OUTER DIAMETER, INNER DIAMETER AND WALL THICKNESS WERE TAKEN. THE CATHETER WAS FOUND TO BE WITHIN SPECIFICATION. THIS COMPLAINT WILL BE RECORDED FOR FUTURE TRENDING AND MONITORING PURPOSES.

Additional Manufacturer Narrative · 0

H11: SECTION A THROUGH F - THE INFORMATION PROVIDED BY BD REPRESENTS ALL OF THE KNOWN INFORMATION AT THIS TIME. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE COMPLAINANT / REPORTER WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO BD.

Description of Event or Problem · 0

IT WAS REPORTED BY THE CUSTOMER THERE IS A HOLE ABOUT 4 CM INTO THE HOSE. DISCOVERED BY LEAKING WHEN ADMINISTERING NACL. INTRODUCED 240821 DISCONTINUED 241029. CATHETER LENGTH 39 CM, SKIN LEVEL 0 CM. VENA BASILICA RIGHT UPPER ARM. ADMISSION, ETC. X-RAY IS AVAILABLE AND IT IS IN A GOOD LOCATION. X-RAY WAS DONE DUE TO ABSENCE OF BACKFLOW. ADDITIONAL INFORMATION: IT WAS REPORTED THE LEAK WAS IN THE PATIENTS VEIN, SO INTERNAL. IT IS REPLACED WITH A NEW ONE. NO HARM TO PATIENT OR STAFF OR EXPOSURE TO BODILY FLUIDS OR BLOOD.

Description of Event or Problem · 0

IT WAS REPORTED BY THE CUSTOMER THERE IS A HOLE ABOUT 4 CM INTO THE HOSE. DISCOVERED BY LEAKING WHEN ADMINISTERING NACL. INTRODUCED 240821 DISCONTINUED 241029. CATHETER LENGTH 39 CM, SKIN LEVEL 0 CM. VENA BASILICA RIGHT UPPER ARM. ADMISSION, ETC. X-RAY IS AVAILABLE AND IT IS IN A GOOD LOCATION. X-RAY WAS DONE DUE TO ABSENCE OF BACKFLOW. ADDITIONAL INFORMATION: IT WAS REPORTED THE LEAK WAS IN THE PATIENTS VEIN, SO INTERNAL. IT IS REPLACED WITH A NEW ONE. NO HARM TO PATIENT OR STAFF OR EXPOSURE TO BODILY FLUIDS OR BLOOD. INFORMATION WAS RECEIVED AND FILE WERE UPDATED FOR THIS EVENT AS PART OF A FOCUS SURVEY. THE FOLLOWING DETAIL WERE PROVIDED: PICC WAS SECURED WITH STATLOCK. IT WAS USED FOR ONCOLOGY TREATMENT. THERE WAS INTERVENTION FOR OCCLUSIONS WITH THIS PICC. IT WAS USED FOR 71 DAYS. THE XRAYS TAKEN ARE NOT AVAILABLE FOR SHARING. CATHETER SITE WAS CLEANED WITH CHLORHEXIDINE SOLUTION POURED FROM A BOTTLE (5MG/ML FROM A BOTTLE). ADDITIONAL COMMENTS: "THERE IS A HOLE ABOUT 4 CM INTO THE HOSE. DISCOVERED BY LEAKING WHEN ADMINISTERING NACL. INTRODUCED 240821 DISCONTINUED 241029 CATHETER LENGTH 39 CM, SKIN LEVEL 0 CM. VENA BASILICA RIGHT UPPER ARM. ADMISSION, ETC. X-RAY IS AVAILABLE AND IT IS IN A GOOD LOCATION 20241002 X-RAY WAS DONE DUE TO ABSENCE OF BACKFLOW, TREATMENT GIVEN 20241003 AND IT WAS FINE. 20241024 NEW TREATMENTS ARE GIVEN AND AFTER THE TREATMENT THEY CAN SEE MOISTURE UNDER THE BANDAGE, BUT JUST RE-APPLY IT BECAUSE I DON'T THINK IT'S A LEAK. 20241028 THE HEALTH CENTER SEES THAT THE CATHETER IS LEAKING, AND IT IS PULLED AT THE HOSPITAL 20241029. THEN FINDS THE HOLE."

Description of Event or Problem · 0

IT WAS REPORTED BY THE CUSTOMER THERE IS A HOLE ABOUT 4 CM INTO THE HOSE. DISCOVERED BY LEAKING WHEN ADMINISTERING NACL. INTRODUCED 240821 DISCONTINUED 241029. CATHETER LENGTH 39 CM, SKIN LEVEL 0 CM. VENA BASILICA RIGHT UPPER ARM. ADMISSION, ETC. X-RAY IS AVAILABLE AND IT IS IN A GOOD LOCATION. X-RAY WAS DONE DUE TO ABSENCE OF BACKFLOW. ADDITIONAL INFORMATION: IT WAS REPORTED THE LEAK WAS IN THE PATIENTS VEIN, SO INTERNAL. IT IS REPLACED WITH A NEW ONE. NO HARM TO PATIENT OR STAFF OR EXPOSURE TO BODILY FLUIDS OR BLOOD. INFORMATION WAS RECEIVED AND FILE WERE UPDATED FOR THIS EVENT AS PART OF A FOCUS SURVEY. THE FOLLOWING DETAIL WERE PROVIDED: PICC WAS SECURED WITH STATLOCK. IT WAS USED FOR ONCOLOGY TREATMENT. THERE WAS INTERVENTION FOR OCCLUSIONS WITH THIS PICC. IT WAS USED FOR 71 DAYS. THE XRAYS TAKEN ARE NOT AVAILABLE FOR SHARING. CATHETER SITE WAS CLEANED WITH CHLORHEXIDINE SOLUTION POURED FROM A BOTTLE (5MG/ML FROM A BOTTLE). ADDITIONAL COMMENTS: "THERE IS A HOLE ABOUT 4 CM INTO THE HOSE. DISCOVERED BY LEAKING WHEN ADMINISTERING NACL. INTRODUCED 240821 DISCONTINUED 241029 CATHETER LENGTH 39 CM, SKIN LEVEL 0 CM. VENA BASILICA RIGHT UPPER ARM. ADMISSION, ETC. X-RAY IS AVAILABLE AND IT IS IN A GOOD LOCATION. ON (B)(6) 2024, X-RAY WAS DONE DUE TO ABSENCE OF BACKFLOW, TREATMENT GIVEN (B)(6) 2024 AND IT WAS FINE. ON (B)(6) 2024, NEW TREATMENTS ARE GIVEN AND AFTER THE TREATMENT THEY CAN SEE MOISTURE UNDER THE BANDAGE, BUT JUST RE-APPLY IT BECAUSE I DON'T THINK IT'S A LEAK. ON (B)(6) 2024, THE HEALTH CENTER SEES THAT THE CATHETER IS LEAKING, AND IT IS PULLED AT THE HOSPITAL (B)(6) 2024. THEN FINDS THE HOLE."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2602006 POWERPICC SOLO CATHETER WITH SHERLOCK 3CG TPS CATHETER,INTRAVASCULAR,THERAPEUTIC,LONG-TERM GREATER THAN 30 DAYS LJS C.R. BARD, INC. (BASD) -3006260740 N/A REJQ0393 00801741138973

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other