BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BD FIRST PICC

    MDR report key: 2495622 · Received February 23, 2012

    Report

    Report Number
    2495622
    Event Type
    Malfunction
    Date Received
    February 23, 2012
    Date of Event
    February 20, 2012
    Report Date
    February 23, 2012
    Manufacturer
    BD
    Product Code
    FOS
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    TN, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE UMBILICAL ARTERIAL CATHETER (UAC) WAS FOUND BROKEN IN THE INFANT'S BED. BOTH PIECES RETRIEVED WITHOUT ANY HARM TO PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BD FIRST PICC CATHETER, UMBILICAL FOS BD * 1066289

    Patients

    Seq Age Sex Outcome Treatment
    1 33 DA