FDA Adverse Event
Other
Summary report: N
BARD ACCESS SYSTEMS
MDR report key: 448010
·
Received March 12, 2003
Report
- Report Number
- MW1027835
- Event Type
- Other
- Date Received
- March 12, 2003
- Date of Event
- February 26, 2003
- Report Date
- March 7, 2003
- Manufacturer
- BARD ACCESS SYSTEMS
- Product Code
- DQO
- Report Source
- Voluntary report
- Reporter Location
- FL, US
- Reporter Occupation
- RISK MANAGER
Narratives
Description of Event or Problem · 1
THE PT HAD A PICC LINE PLACEMENT IN THE RIGHT ARM WITH A DOPPLER ASSIST. THE INTRODUCER WAS INSERTED AND THE NEEDLE WAS WITHDRAWN WITH THE INTRODUCER SHEATH INSIDE THE VEIN. AS THE CATHETER WAS ADVANCED, RESISTENCE WAS MET. THE PROCEDURE WAS STOPPED AND THE INTRODUCER SHEATH WAS WITHDRAWN. THE NEEDLE WAS INSPECTED AND THE OUTSIDE LAYER WAS MISSING. PT WAS TAKEN TO RADIOLOGY FOR SUCCESSFUL REMOVAL OF THE NEEDLE / INTRODUCER DEVICE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | BARD ACCESS SYSTEMS | PER-Q-CATH 4 FRENCH PICC LINE | DQO | BARD ACCESS SYSTEMS | * | 22DMA683 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 51 YR | Other |