BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ARROW

    MDR report key: 280114 · Received May 30, 2000

    Report

    Report Number
    MW1019024
    Event Type
    Injury
    Date Received
    May 30, 2000
    Date of Event
    May 15, 2000
    Report Date
    May 19, 2000
    Manufacturer
    ARROW INT'L, INC.
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IN, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    COMPLICATIONS WITH INSERTION OF CENTRAL LINE. GUIDE WIRE INSERTED, UNABLE TO REMOVE. FLUOROSCOPY USED. CARDIOVASCULAR SURGEON RETRIEVED PORTION OF RETAINED WIRE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ARROW TWO LUMEN CENTRAL VENOUS CATHETER DQO ARROW INT'L, INC. AK 22702 OC 1595

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Required Intervention