MalfunctionFOX
STATLOCK CV PLUS SLIDING POST, TRICOT HYDROCOLLOID CRESCENT PD, PIGTAIL PD, 25
Received Apr 26, 2021 · Event occurred Mar 3, 2021
Report 3006260740-2021-01544 · MDR key 11727074
Device
Generic name
Stand, Infusion
Manufacturer
C.r. Bard, Inc. (basd) -3006260740Model number
NACatalog number
CV0220CE
Lot number
JUFN1795
Product problems
- Misconnection
- Misconnection
Patient
48 YR
- 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 JUFN1795 SHOWED NO OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER.
Description of Event or Problem
IT WAS REPORTED THAT ON (B)(6), 2021, THE PATIENT WAS ADMITTED TO THE HOSPITAL FOR PICC CATHETER MAINTENANCE. WHEN USING THE CATHETER HOLDER, IT WAS FOUND THAT THE BUCKLE WAS NOT TIGHT, AND THE CATHETER HOLDER WAS REPLACED WITHOUT ADVERSE CONSEQUENCES.