BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CVC KIT CDC

    MDR report key: 2081251 · Received April 28, 2011

    Report

    Report Number
    2081251
    Event Type
    Malfunction
    Date Received
    April 28, 2011
    Date of Event
    February 9, 2011
    Report Date
    April 28, 2011
    Manufacturer
    ARROW
    Product Code
    DQY
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NV, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    ANESTHESIA COMPLAINED THAT NEEDLE HOLDER (14) UB CENTRAL LINE KIT WAS NOT HOLDING/CLAMPING SUTURE WHILE CENTRAL LINE TO NECK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CVC KIT CDC CVC KIT, CDC DQY ARROW * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *