BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TWO-LUMEN CENTRAL VENOUS CATHETERIZATION KIT WITH BLUE FLEXTIP, ARROWG+ARD BLUE

    MDR report key: 2581716 · Received May 9, 2012

    Report

    Report Number
    2581716
    Event Type
    Malfunction
    Date Received
    May 9, 2012
    Date of Event
    January 19, 2012
    Report Date
    May 9, 2012
    Manufacturer
    TELEFLEX INC.
    Product Code
    DQY
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TWO-LUMEN CENTRAL VENOUS CATHETERIZATION KIT WITH BLUE FLEXTIP, ARROWG+ARD BLUE CATHETER, PERCUTANEOUS DQY TELEFLEX INC. CDC-42802-1A RF1082723

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR