FDA Adverse Event Injury Summary report: N

RA CATH SET: 20 GA X 1-3/4"

MDR report key: 2193549 · Received October 4, 2007

Report

Report Number
9680794-2007-00014
Event Type
Injury
Date Received
October 4, 2007
Date of Event
August 23, 2007
Report Date
October 5, 2007
Manufacturer
ARROW INTERNATIONAL, INC.
Product Code
DQX
PMA / PMN Number
K810675
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). A F/U REPORT WILL BE FILED IF MORE INFO BECOMES AVAILABLE.

Description of Event or Problem · 1

IT WAS REPORTED THAT PT WITH HISTORY OF HYPERTENSION WAS BROUGHT IN BY AMBULANCE FOR RIGHT MYOCARDIAL INFARCTION, WITH TPA ADMINISTERED IN EMERGENCY DEPT. SYMPTOMS IMPROVED AND PT WAS TRANSFERRED TO ICU. THE FOLLOWING DAY AN ARTERIAL LINE WAS INSERTED. AT TIME OF PLACEMENT, WHEN TRYING TO SUTURE AROUND HUB OF CATHETER, THE CATHETER SNAPPED LEAVING CATHETER TIP INSIDE ARTERY. A VASCULAR SURGEON WAS CALLED STAT AND A CUT DOWN ATTEMPTED WHICH WAS UNSUCCESSFUL IN REMOVING CATHETER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RA CATH SET: 20 GA X 1-3/4" RADIAL ARTERY PRODUCTS DQX ARROW INTERNATIONAL, INC. NA CF7037360

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention INPATIENT ACUTE REHABILITATION| TPA