BEUDAMED
    FDA Adverse Event Other Summary report: N

    V-CATH 5 FR

    MDR report key: 501768 · Received November 18, 2003

    Report

    Report Number
    2925153-2003-00013
    Event Type
    Other
    Date Received
    November 18, 2003
    Date of Event
    October 22, 2003
    Report Date
    October 31, 2003
    Manufacturer
    HDC CORP.
    Product Code
    DQO
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    "BREAK. CATHETERS, TWO, SNAPPED RIGHT BELOW THE REDUCTION POINT. PATIENT OK. CATHETER RETRIEVED."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH 5 FR PICC CATHETER DQO HDC CORP. 502-266 1070

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention