BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HICKMAN 7F DUAL-LUMEN CV CATHETER

    MDR report key: 3811173 · Received March 10, 2014

    Report

    Report Number
    MW5036069
    Event Type
    Injury
    Date Received
    March 10, 2014
    Date of Event
    February 11, 2014
    Report Date
    February 19, 2014
    Manufacturer
    BARD ACCESS SYSTEM, INC.
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    ON (B)(6) 2013, PT HAD A 7 FRENCH HICKMAN DUAL-LUMEN TUNNELED CENTRAL VENOUS CATHETER PLACED. ON (B)(6) 2014, THE CATHETER WAS REMOVED. THE CATHETER BROKE DURING THE ATTEMPTED REMOVAL. A SECOND DERMOTOMY WAS REQ'D TO REMOVE TUNNELED CATHETER AS IT HAD BECOME SIGNIFICANTLY SCARRED IN PLACE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    143616 HICKMAN 7F DUAL-LUMEN CV CATHETER NONE LJT BARD ACCESS SYSTEM, INC. 0600570

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Required Intervention