FDA Adverse Event Other Summary report: N

V-CATH

MDR report key: 633572 · Received September 8, 2005

Report

Report Number
2925153-2005-00053
Event Type
Other
Date Received
September 8, 2005
Report Date
September 8, 2005
Manufacturer
HDC CORP.
Product Code
DQO
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SF
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

LINE WAS INSERTED, COULD NOT PULL THE SAFE-T-PEEL OTN INTRODUCER SHEATH APART; OTN WING SNAPPED. LINE WAS REMOVED INTACT. PROBLEM WITH THE OTN INTRODUCER NOT THE CATHETER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 V-CATH ACCESS DEVICE DQO HDC CORP. 355-75 1074

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN