FDA Adverse Event Other Summary report: N

V-CATH

MDR report key: 474875 · Received July 25, 2003

Report

Report Number
2925153-2003-00006
Event Type
Other
Date Received
July 25, 2003
Date of Event
January 1, 2003
Report Date
July 1, 2003
Manufacturer
HDC CORP.
Product Code
DQO
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NZ
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

FIRST REPORTED AS "FAULTY PRODUCT". ADDITIONAL INFO NOW STATES THE LINE WAS REMOVED AFTER 14 DAYS OF AUGMENTIN (AMOXACILLN AND CLAVULANIC ACID) "1 GRAM 8 HOURLY". DURING EACH ADMINISTRATION THE LINK WAS FLUSHED WITH NORMAL SALINE AND LOCKED OFF WITH 3 MLS OF HEPARINIZED SALINE, 10 UNITS / ML. THE NURSE MEASURED THE PICC AFTER REMOVAL AND REALIZED 5CM HAD BROKEN OFF. THE PT WAS TAKEN TO THEATER AND 5CM OF CATHETER WAS REMOVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 V-CATH PICC CATHETER DQO HDC CORP. NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention