inforMED
MalfunctionFOX

STATLOCK SLIDING POST CRESCENT

Received Feb 26, 2021 · Event occurred Jan 28, 2021

Report 3006260740-2021-00524 · MDR key 11389219

Device

Generic name

Stand, Infusion

Catalog number

PIC0220

Lot number

JUEV1827

Product problems

  • Detachment of Device or Device Component

Narrative

Additional Manufacturer Narrative

THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER FOR EVALUATION. A LOT HISTORY REVIEW (LHR) OF JUEV1827 SHOWED NO OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER.

Description of Event or Problem

IT WAS REPORTED WHEN DOING A DRESSING CHANGE AND REMOVING THE STATLOCK, THE PLASTIC WINGS DETACHED FROM THE STATLOCK ADHESIVE ALMOST PULLING THE PICC OUT OF THE PATIENT. ADDITIONAL INFORMATION RECEIVED 02/01/2021: DOES THE PATIENT HAVE AN INFECTIOUS DISEASE? UNKNOWN, MY DEPARTMENT DID NOT TAKE NOTE OF THE PARTICULAR PATIENTS THIS IS HAPPENING TO. WE ASSUME IT IS THE PRODUCT. I WILL SAY THAT A CONTRIBUTING FACTOR, IN HINDSIGHT, MAY BE USING SENSICARE ADHESIVE RELEASE SPRAY TO REMOVE DRESSINGS. PERHAPS IT IS REMOVING THE ADHESIVE UNDER THE PLASTIC WINGS.