BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ASH SPLIT CATHETER

    MDR report key: 374285 · Received January 25, 2002

    Report

    Report Number
    2518902-2002-00001
    Event Type
    Injury
    Date Received
    January 25, 2002
    Date of Event
    September 16, 2001
    Report Date
    January 2, 2002
    Manufacturer
    MEDCOMP MEDICAL COMPONENTS, INC
    Product Code
    MSD
    Report Source
    Manufacturer report
    Reporter Location
    WY, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE "PT LEANED OVER TOILET WRETCHING DUE TO NAUSEA AND NOTICED HEMODIALYSIS CATHETER ON THE FLOOR. PT COVERED EXIT SITE AND WENT TO EMERGENCY ROOM. CATHETER INSERTED AS TUNNELED RT INTERNAL JUGULAR WITH SUBCLAVIAN EXIT SITE. SUTURES REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ASH SPLIT CATHETER HEMODIALYSIS CATHETER MSD MEDCOMP MEDICAL COMPONENTS, INC NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR