BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    V-CATH

    MDR report key: 382126 · Received March 13, 2002

    Report

    Report Number
    MW1024369
    Event Type
    Malfunction
    Date Received
    March 13, 2002
    Date of Event
    March 12, 2002
    Report Date
    March 12, 2002
    Manufacturer
    HDC CORP
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE 395-50 5.0 FR DUAL LUMEN PICC LOT 1065 FOUND TO HAVE A "TAG" LIKE PROJECTION NEAR THE PROXIMAL LUMEN. ANOTHER PRODUCT WAS USED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH PICC DQO HDC CORP 395 50 1065

    Patients

    Seq Age Sex Outcome Treatment
    1 22 YR