FDA Adverse Event
Injury
Summary report: N
FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER
MDR report key: 395715
·
Received May 20, 2002
Report
- Report Number
- 1710034-2002-00012
- Event Type
- Injury
- Date Received
- May 20, 2002
- Date of Event
- April 1, 2002
- Report Date
- May 15, 2002
- Manufacturer
- BECTON DICKINSON INFUSION THERAPY SYSTEMS
- Product Code
- DQO
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- NURSE
Narratives
Description of Event or Problem · 1
RIGHT PLEURAL EFFUSION (CXR), PICC DC'D (TIP SUBCLAVIAN BY CXR) PLEURAL TAP (INFUSING D7HAL WHEN D/C'D).
Description of Event or Problem · 1
1.9 FR CATHETER PLACED IN NICU IN 03/2002 BY NURSE. INITIAL X-RAY READING REPORTED AS BRACHIAL BASILIC AND LATER SUBCLAVIAN. D17 TPN SOLUTION INFUSED, PLEURAL EFFUSION DEVELOPED AND CATHETER REMOVED 04/2002. TIP PLACEMENT AT BRACHIOCEPHALIC WITH X-RAY CONFIRMATION. LINE WAS SECURED WITH OPSITE DRESSING ON TOP OF CATHETER MATERIAL. PATIENT RE-X-RAYED TO CONFIRM TIP HAD MOVED TO SUBCLAVIAN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER | PERCUTANEOUS CATHETER | DQO | BECTON DICKINSON INFUSION THERAPY SYSTEMS | NA | 108840 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NO INFO | Required Intervention |