inforMED
MalfunctionFOX

STATLOCK SLIDING POST TRICOT CRESCENT PAD INCLUDES SKIN PREP

Received Mar 19, 2021 · Event occurred Feb 25, 2021

Report 3006260740-2021-00904 · MDR key 11531525

Device

Generic name

Stand, Infusion

Catalog number

PIC0220CE

Lot number

JUEV0698

Product problems

  • Detachment of Device or Device Component
  • Detachment of Device or Device Component

Patient

Not reported

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER FOR EVALUATION. A LOT HISTORY REVIEW (LHR) OF JUEV0698 SHOWED NO OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER. DEVICE NOT RETURNED FOR EVALUATION.

Description of Event or Problem

IT WAS REPORTED THE PATIENT HAD A STATLOCK FOR HIS CDC. THEY DISCOVERED THAT THE PLASTIC LOCK HAD BROKEN FROM THE STATLOCK AND THE CATHETER ALMOST LOST. NO OTHER INFORMATION WAS PROVIDED.