BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MORPHEUS SMART PICC

    MDR report key: 3092162 · Received April 30, 2013

    Report

    Report Number
    MW5030019
    Event Type
    Injury
    Date Received
    April 30, 2013
    Date of Event
    April 20, 2013
    Report Date
    April 23, 2013
    Manufacturer
    ANGIODYNAMICS
    Product Code
    LJS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NM, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PICC LINE PLACED (B)(6) 2013. FRACTURED CATHETER NOTED ON (B)(6) 2013. PICC REPLACED. NO EVIDENCE OF CLABSI AS OF (B)(6) 2013. NO UNTOWARD EFFECTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    187355 MORPHEUS SMART PICC NONE LJS ANGIODYNAMICS 12110934 C86812

    Patients

    Seq Age Sex Outcome Treatment
    1 65 YR Required Intervention