MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-06-12 for UNKNOWN manufactured by Unknown.
[77314611]
Patient Sequence No: 1, Text Type: N, H10
[77314612]
Nurse removed iv catheter. The end catheter piece that goes into the vein became detached from the iv lock and stayed in the patient. The nurse had to remove the piece.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 6633296 |
| MDR Report Key | 6633296 |
| Date Received | 2017-06-12 |
| Date of Report | 2017-05-03 |
| Date of Event | 2015-09-09 |
| Report Date | 2017-05-03 |
| Date Reported to FDA | 2017-05-03 |
| Date Reported to Mfgr | 2017-05-03 |
| Date Added to Maude | 2017-06-12 |
| 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 | 3 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | UNKNOWN |
| Generic Name | DUAL LUMEN IV LOCK |
| Product Code | EYB |
| Date Received | 2017-06-12 |
| Model Number | UNKNOWN |
| Catalog Number | UNKNOWN |
| Lot Number | UNKNOWN |
| Operator | NURSE |
| Device Availability | Y |
| Device Age | 1 DY |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | UNKNOWN |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-06-12 |