BEUDAMED
    FDA Adverse Event Other Summary report: N

    V-CATH PICC

    MDR report key: 57804 · Received December 24, 1996

    Report

    Report Number
    MW1010455
    Event Type
    Other
    Date Received
    December 24, 1996
    Date of Event
    December 21, 1996
    Report Date
    December 23, 1996
    Manufacturer
    HDC CORP.
    Product Code
    DQO
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    UT, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    12/18/96 PT ON HYDRATION AND ANTI-EMETIC THERAPY CATHETER CUT TO 12 INCHES AND PLACED IN (L) CEPHALLIC VEIN. ARM CIRCUMFERANCE WAS 12 1/2 INCHES, 4 INCHES UP FROM (L) AC. GOOD BLOOD RETURN, FLUSHED EASILY. PLACED WITH ONE ATTEMPT, LINE THREADED EASILY. PT INSTRUCTED ON PROPER FLUSHING AND INSTRUCTED TO USE WARM, MOIST HEAT FOR 48 HRS. 12/19/96 24 HRS AFTER INSERTION DSG CHANGED WITH S/S OF PHLEBITIS NOTED. ONLY SMALL 1/2 INCH SIZE DRIED BLOOD ON 2 X 2 SQUARE DSG. LINE FLUSHED EASILY. 12/21/96 PT CALLED WITH C/O TENDERNESS TO (L) BICEP AREA AND RED LINE NOTED, (L) ARM CIRCUM 12 3/4". PT INSTRUCTED, AGAIN TO CLEVATE ARM, USE WARM, MOIST HEAT AND TAKE 2 ASA QID. 12/22/96 S/S NF PHLEBITIS NOT RESOLVED. LONG LINE PULLED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V-CATH PICC Implant PERIPHERALLY INSERTED CENTRAL CATHETER DQO HDC CORP. 380-55 1042

    Patients

    Seq Age Sex Outcome Treatment
    1 22 YR Other