BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HDC CORPORATION

    MDR report key: 505391 · Received December 24, 2003

    Report

    Report Number
    505391
    Event Type
    Injury
    Date Received
    December 24, 2003
    Date of Event
    November 7, 2003
    Report Date
    December 4, 2003
    Manufacturer
    HDC CORPORATION
    Product Code
    DQO
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    CO, US
    Reporter Occupation
    RISK MANAGER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HDC CORPORATION 5.0 FR. DUAL LUMEN PICC DQO HDC CORPORATION UNK 1059

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Required Intervention