BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ABBOTT

    MDR report key: 285165 · Received July 6, 2000

    Report

    Report Number
    285165
    Event Type
    Malfunction
    Date Received
    July 6, 2000
    Date of Event
    June 15, 2000
    Report Date
    June 28, 2000
    Manufacturer
    ABBOTT
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    MD ATTEMPTED TO INSERT CENTRAL LINE 3 TIMES BUT DUE TO CATHETER MALFUNCTION, MD NEEDED TO USE A DIFFERENT BRAND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ABBOTT 3LUMEN CENTRAL CATH KIT DQO ABBOTT 41401-04-13 63497-SN

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Other