MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1998-02-03 for V CATH/HDC * manufactured by V Cath / Hdc.
[105582]
Peripherally inserted central catheter line broke at time of removal, with approx 9" remaining in the left cephalic vein. Sent to emergency room where broken catheter was removed.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 172797 |
| MDR Report Key | 172797 |
| Date Received | 1998-02-03 |
| Date of Report | 1998-02-03 |
| Date of Event | 1998-02-02 |
| Date Facility Aware | 1998-02-02 |
| Report Date | 1998-02-03 |
| Date Reported to FDA | 1998-02-03 |
| Date Added to Maude | 1998-06-18 |
| Event Key | 0 |
| Report Source Code | User Facility report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | V CATH/HDC |
| Generic Name | PICC CATHETER |
| Product Code | HDC |
| Date Received | 1998-02-03 |
| Model Number | * |
| Catalog Number | * |
| Lot Number | 1064 A |
| ID Number | 3 FRENCH V CATH PICC |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | UNKNOWN |
| Implant Flag | Y |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 168019 |
| Manufacturer | V CATH / HDC |
| Manufacturer Address | 2109 O'TOOLE AVE SAN JOSE CA 95131 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Hospitalization | 1998-02-03 |