FDA Adverse Event
Malfunction
Summary report: N
DUAL LUMEN L-CATH PICC CATHETER
MDR report key: 2080092
·
Received April 6, 2011
Report
- Report Number
- 1625425-2011-00038
- Event Type
- Malfunction
- Date Received
- April 6, 2011
- Report Date
- April 6, 2011
- Manufacturer
- ARGON MEDICAL DEVICES, INC.
- Product Code
- DQX
- PMA / PMN Number
- K925979
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MA, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
RESULTS OF INVESTIGATION WILL BE FILED IN A SUPPLEMENTAL REPORT.
Description of Event or Problem · 1
CATHETER BROKE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | DUAL LUMEN L-CATH PICC CATHETER | DQX | ARGON MEDICAL DEVICES, INC. | NA | 0214361 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK |