FDA Adverse Event Other Summary report: N

CIRCLE C SILICONE CATHETER KIT

MDR report key: 242295 · Received September 28, 1999

Report

Report Number
1056436-1999-00166
Event Type
Other
Date Received
September 28, 1999
Date of Event
September 8, 1999
Report Date
September 9, 1999
Manufacturer
HORIZON MEDICAL TECHNOLOGIES/HORIZON MEDICAL PRODUCTS, INC.
Product Code
LFJ
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

ON 09/09/1999, THE FACILITY'S RN, RADIOLOGY SUPERVISOR INFORMED THE MANUFACTURER'S (MFR) SALES REP OF THE FOLLOWING: THE CATHETER WAS INSERTED AND THEN BLOOD RETURNED WAS CHECKED. THE RED RETURN WAS SEEN TO HAVE A SMALL HOLE IN THE EXTENSION. NO FURTHER DETAILS WERE PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CIRCLE C SILICONE CATHETER KIT Implant CHRONIC SILICONE CATHETER LFJ HORIZON MEDICAL TECHNOLOGIES/HORIZON MEDICAL PRODUCTS, INC. NA SE99060

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other