FDA Adverse Event Malfunction Summary report: N

ARROW CATH PKGD: WEDGE 5 FR 110CM

MDR report key: 22749656 · Received August 8, 2025

Report

Report Number
3010532612-2025-00735
Event Type
Malfunction
Date Received
August 8, 2025
Date of Event
July 11, 2025
Report Date
July 14, 2025
Manufacturer
ARROW INTERNATIONAL LLC
Product Code
DYG
UDI-DI
00801902002853
PMA / PMN Number
K892530
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

QN# (B)(4).

Additional Manufacturer Narrative · 0

(B)(4) UPON FURTHER REVIEW, IT WAS DETERMINED THAT THIS COMPLAINT WAS CREATED IN ERROR, THUS, THE INITIAL MDR SUBMITTED ON 08/08/2025 SHOULD BE RETRACTED.

Description of Event or Problem · 0

IT WAS REPORTED "WE USED 3 EACH ARROW 5F BWP CATHETERS ON A PATIENT TODAY BECAUSE TWO OFTHEM DREW BACK AIR WHEN THE DR TRIED TO PULL BACK BLOOD; ONE APPEARS TO HAVE A HOLE IN IT AND THE OTHER A CRACK---ON THE HUBS? THERE WAS NO DIFFICULTY CONNECTING IT TO THE CATHETER NOR DISCONNECTING IT FROM THE CATHETER". NO PATIENT INJURY OR CONSEQUENCE REPORTED. THE PATIENT'S CURRENT CONDITION IS "UNKNOWN". PLEASE SEE ASSOCIATED MDR #: 3010532612-2025-00720, 3010532612-2025-00736.

Description of Event or Problem · 0

IT WAS REPORTED "WE USED 3 EACH ARROW 5F BWP CATHETERS ON A PATIENT TODAY BECAUSE TWO OFTHEM DREW BACK AIR WHEN THE DR TRIED TO PULL BACK BLOOD; ONE APPEARS TO HAVE A HOLE IN IT AND THE OTHER A CRACK---ON THE HUBS? THERE WAS NO DIFFICULTY CONNECTING IT TO THE CATHETER NOR DISCONNECTING IT FROM THE CATHETER". NO PATIENT INJURY OR CONSEQUENCE REPORTED. THE PATIENT'S CURRENT CONDITION IS "UNKNOWN". PLEASE SEE ASSOCIATED MDR #: 3010532612-2025-00720 ,3010532612-2025-00736, 3010532612-2025-00735.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
223898 ARROW CATH PKGD: WEDGE 5 FR 110CM CATHETER, FLOW DIRECTED DYG ARROW INTERNATIONAL LLC 16F25E0084 00801902002853

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown