BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PERIPHERALLY INSERTED CENTRAL CATHETER

    MDR report key: 36457 · Received September 4, 1996

    Report

    Report Number
    MW1009855
    Event Type
    Malfunction
    Date Received
    September 4, 1996
    Date of Event
    July 25, 1996
    Report Date
    July 29, 1996
    Manufacturer
    LUTHER MEDICAL PRODUCTS, INC.
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT'S PICC LINE WAS PLACED 7/22/96 AT THE HOSP. WAS FLUSHING VERY SLUGGISHLY AND WITH SOME PRESSURE NEEDED TO FLUSH. ATTEMPTED TO FLUSH WITH UROKINASE TWICE BUT WAS UNSUCCESSFUL. LINE WAS PULLED ON 7/25/96 BECAUSE IT WOULD NO LONGER FLUSH AND WAS NON-FUNCTIONAL. CXR INDICATED CATHETER WAS INTACT AND IN CORRECT PLACEMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PERIPHERALLY INSERTED CENTRAL CATHETER Implant PERIPHERALLY INSERTED CENTRAL CATHETER DQO LUTHER MEDICAL PRODUCTS, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR Other