FDA Adverse Event
Other
Summary report: N
BD FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER
MDR report key: 856121
·
Received May 4, 2007
Report
- Report Number
- 1710034-2007-00036
- Event Type
- Other
- Date Received
- May 4, 2007
- Date of Event
- April 9, 2007
- Report Date
- May 3, 2007
- Manufacturer
- BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC.
- Product Code
- LJS
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
THE SAMPLE WAS RECEIVED ON 25 APRIL 2007 AND IS CURRENTLY BEING DECONTAMINATED. UPON DECONTAMINATION AND COMPLETION OF THE INVESTIGATION, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.
Description of Event or Problem · 1
THE PICC WAS PLACED IN THE RIGHT ARM. THE CATHETER BROKE WHILE INDWELLING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | BD FIRST PICC PERIPHERALLY INSERTED CENTRAL CATHETER | PERCUTANEOUS CATHETER | LJS | BECTON DICKINSON INFUSION THERAPY SYSTEMS, INC. | NA | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 76 YR | Other |