STATLOCK PICC PLUS CRESCENT SLIDING POST
Received Feb 10, 2021 · Event occurred Jan 19, 2021
Report 3006260740-2021-00288 · MDR key 11310958
Device
Generic name
Stand, Infusion
Manufacturer
C.r. Bard, Inc. (basd) -3006260740Model number
N/ACatalog number
PIC0220
Lot number
JUEU2085
Product problems
- Detachment of Device or Device Component
Patient
Not reported
- No Consequences Or Impact To Patient
- No Consequences Or Impact To Patient
Narrative
Additional Manufacturer Narrative
THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER FOR EVALUATION. A LOT HISTORY REVIEW (LHR) OF JUEU2085 SHOWED ONE OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER. THE COMPLAINTS FOR THIS LOT NUMBER (JUEU2085) HAVE BEEN REPORTED FROM THE SAME FACILITY. DEVICE NOT RETURNED FOR EVALUATION.
Description of Event or Problem
IT WAS REPORTED "PICC PLUS STATLOCK CATHETER STABILIZATION DEVICE: PLASTIC WINGS DETACHED FROM ADHESIVE BASE DURING ROUTINE APPLICATION." "PATIENT REQUIRED ADDITIONAL STATLOCK APPLICATION/DRESSING CHANGE"