FDA Adverse Event Other Summary report: N

PHERES-FLOW CENTRAL VENOUS CATHETER KIT

MDR report key: 275995 · Received May 3, 2000

Report

Report Number
1056436-2000-00084
Event Type
Other
Date Received
May 3, 2000
Date of Event
April 4, 2000
Report Date
April 4, 2000
Manufacturer
NEOSTAR MEDICAL TECHNOLOGIES/HORIZON MEDICAL PRODUCTS, INC.
Product Code
FJS
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
RADIOLOGIC TECHNOLOGIST

Narratives

Description of Event or Problem · 1

ON 04/04/2000, THE FACILITY'S RADIOLOGY TECHNICIAN INFORMED THE MANUFACTURER'S (MFR.) SALES REPRESENTATIVE OF THE FOLLOWING: AS THE PHYSICIAN WAS PUTTING IN THE CATHETER THE CUFF FELL OFF. NO FURTHER DETAILS WERE PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PHERES-FLOW CENTRAL VENOUS CATHETER KIT CHRONIC SILICONE CATHETER FJS NEOSTAR MEDICAL TECHNOLOGIES/HORIZON MEDICAL PRODUCTS, INC. NA SE99117

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other