BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FOOTPRINT PERIPHERALLY INSERTED CENTRAL CATHETER

    MDR report key: 25209174 · Received May 18, 2026

    Report

    Report Number
    MW5188369
    Event Type
    Malfunction
    Date Received
    May 18, 2026
    Date of Event
    May 7, 2026
    Report Date
    May 13, 2026
    Manufacturer
    FOOTPRINT MEDICAL INC.
    Product Code
    LJS
    UDI-DI
    00858778006058
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    KY, US
    Reporter Occupation
    RISK MANAGER
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    DURING PERIPHERALLY INSERTED CENTRAL CATHETER LINE INSERTION ATTEMPT USING 1.4 FRENCH PICC LINE ( LOT#250584 EXPIRATION 2027-08-07) CATHETER SEPARATED/BROKE WHILE HUB WAS BEING REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    133832 FOOTPRINT PERIPHERALLY INSERTED CENTRAL CATHETER CATHETER, INTRAVASCULAR, THERAPEUTIC, LONG-TERM GREATER THAN 30 DAYS LJS FOOTPRINT MEDICAL INC. 250584 00858778006058

    Patients

    Seq Age Sex Outcome Treatment
    1