BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DUAL-LUMEN HICKMAN CATHETER

    MDR report key: 3803016 · Received May 5, 2014

    Report

    Report Number
    MW5035963
    Event Type
    Injury
    Date Received
    May 5, 2014
    Date of Event
    April 26, 2014
    Report Date
    April 28, 2014
    Manufacturer
    BARD ACCESS SYSTEMS, INC
    Product Code
    LJS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE 7 F TUNNELED DUAL LUMEN HICKMAN CATHETER WAS INSERTED ON (B)(6) 2014. REMOVED ON (B)(6) 2014 BECAUSE PT COMPLAINT OF HEARING POP AFTER WHITE PORT OF CATHETER WAS FLUSHED. PT ALSO EXPERIENCED PAIN AT CATHETER SITE. CATHETER WAS NOTED TO BE PERFORATED. MFR: PLEASE NOTE THAT WE DO NOT SEND PRODUCTS TO THE MFR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    267867 DUAL-LUMEN HICKMAN CATHETER HICKMAN CATHETER LJS BARD ACCESS SYSTEMS, INC HUYA0317

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Required Intervention