BEUDAMED
    FDA Adverse Event Injury Summary report: N

    V-CATH

    MDR report key: 394440 · Received January 30, 2002

    Report

    Report Number
    2925153-2002-00017
    Event Type
    Injury
    Date Received
    January 30, 2002
    Date of Event
    September 17, 2001
    Report Date
    November 30, 2001
    Manufacturer
    HDC CORPORATION
    Product Code
    DQO
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SF
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    BASED ON THE DATA RECEIVED: A LINE WAS PLACED IN A PT. LINE BECAME STUCK. SURGICALLY REMOVED. PT IS FINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH CATHETER DQO HDC CORPORATION UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention