BEUDAMED
    FDA Adverse Event Other Summary report: N

    CENTERMARK CATHETER

    MDR report key: 36942 · Received September 6, 1996

    Report

    Report Number
    MW1009885
    Event Type
    Other
    Date Received
    September 6, 1996
    Date of Event
    August 26, 1996
    Report Date
    August 27, 1996
    Manufacturer
    MENLO CARE, INC.
    Product Code
    DQO
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CO, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    IMMEDIATELY AFTER THE PLACING OF A 4.0 FR PICC, THE PT BEGAN TO HAVE ABDOMINAL CRAMPS. CHEST TIGHTNESS, SOB AND FACIAL STINGING. BP 180/120 HR=110. PT WAS VERY FLUSHED AND ANXIOUS. NORMAL BREATH SOUNDS WITHOUT WHEEZING. PICC PULLED IMMEDIATELY AND ALL SIGNS AND SYMPTOMS GONE WITHIN 5-10 MINS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CENTERMARK CATHETER Implant PERIPHERALLY INSERTED CENTRAL CATHETER DQO MENLO CARE, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 34 YR Other