ARROW INTERNATIONAL DILATOR CL-07024

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-06-02 for ARROW INTERNATIONAL DILATOR CL-07024 manufactured by Arrow International.

Event Text Entries

[76841491] The hub from 10 fr arrow dilator broke off outside the body leaving the dilator stuck inside the left femoral vein.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5070184
MDR Report Key6614222
Date Received2017-06-02
Date of Report2017-06-02
Date of Event2017-06-01
Date Added to Maude2017-06-06
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameARROW INTERNATIONAL DILATOR
Generic NameDILATOR
Product CodeGCC
Date Received2017-06-02
Model NumberCL-07024
Lot Number14F16G0580
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerARROW INTERNATIONAL
Manufacturer AddressREADING PA US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2017-06-02

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