BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PICC CATHETER

    MDR report key: 226367 · Received June 7, 1999

    Report

    Report Number
    MW1016480
    Event Type
    Injury
    Date Received
    June 7, 1999
    Date of Event
    April 30, 1999
    Report Date
    June 4, 1999
    Manufacturer
    LUTHER MEDICAL PRODUCTS, INC.
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NY, US
    Reporter Occupation
    PHARMACIST

    Narratives

    Description of Event or Problem · 1

    RED HUB ON PICC LINE CRIMPS, THUS MIMICS OCCLUSION. UPON UNCRIMPING, PICC FUNCTIONS NORMALLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PICC CATHETER PERIPHERALLY INSERTED CENTRAL CATHETER DQO LUTHER MEDICAL PRODUCTS, INC. * LMP5852

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Required Intervention