BEUDAMED
    FDA Adverse Event Injury Summary report: N

    V-CATH (HDC CORPORATION)

    MDR report key: 374122 · Received January 24, 2002

    Report

    Report Number
    MW1023906
    Event Type
    Injury
    Date Received
    January 24, 2002
    Date of Event
    October 1, 2001
    Report Date
    January 24, 2002
    Manufacturer
    *
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    3.0 FR V-CATH PICC LINE REMOVED BY SPECIAL PROCEDURES DEPT. FRACTURED PIECES OF PICC LEFT IN PT. PT PERSISTED WITH 2 DAY HX SWEATS, NO TEMP, CHILLS, SHORTNESS OF BREATH. PIECE OF PICC FOUND WITH CXR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH (HDC CORPORATION) PICC LINE 3.0 FRENCH DQO * * 1008

    Patients

    Seq Age Sex Outcome Treatment
    1 49 YR Life Threatening