BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    V-CATH DUAL LUMEN PICC LINE

    MDR report key: 49998 · Received November 15, 1996

    Report

    Report Number
    MW1010271
    Event Type
    Malfunction
    Date Received
    November 15, 1996
    Date of Event
    October 31, 1996
    Report Date
    October 31, 1996
    Manufacturer
    HDC
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    (R) BASILIC PICC CATHETER LEAKING AT BASE OF JUNCTION WHEN EACH LUMEN FLUSHED. LINE DISCONTINUED AT THAT TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH DUAL LUMEN PICC LINE PERIPHERALLY INSERTED CENTRAL CATHETER DQO HDC 395-50 1021

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Other