BEUDAMED
    FDA Adverse Event Injury Summary report: N

    V-CATH 2 FR.

    MDR report key: 254758 · Received December 17, 1999

    Report

    Report Number
    2925153-1999-00007
    Event Type
    Injury
    Date Received
    December 17, 1999
    Date of Event
    September 1, 1999
    Report Date
    December 17, 1999
    Manufacturer
    HDC CORP.
    Product Code
    DQO
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    BASED ON THE REPORT, SENT TO HDC IN NOVEMBER 1999, ONE CATHETER BROKE AFTER ONE WEEK IN PLACE. SURGICAL INTERVENTION WAS NEEDED TO REMOVE. PT IS FINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH 2 FR. PICC DQO HDC CORP. 352-45 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other