BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    V-CATH PICC

    MDR report key: 352638 · Received September 20, 2001

    Report

    Report Number
    MW1022896
    Event Type
    Malfunction
    Date Received
    September 20, 2001
    Date of Event
    September 12, 2001
    Report Date
    September 20, 2001
    Manufacturer
    HDC
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WIRE "HUNG UP" IN CATHETER. ABORTED PROCEDURE WITH SELDINGER INTRODUCER IN PLACE. ANOTHER 395-60 DUAL PICC 5.0 FOTN KIT USED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    42988 V-CATH PICC SILICONE CATHETER DQO HDC 395-60 1072

    Patients

    Seq Age Sex Outcome Treatment
    1 37 YR Other