MalfunctionFOX
STATLOCK PICC PLUS CRESCENT SLIDING POST
Received May 7, 2021 · Event occurred Apr 8, 2021
Report 3006260740-2021-01762 · MDR key 11792697
Device
Generic name
Set, Administration, Intravascular
Manufacturer
C.r. Bard, Inc. (basd) -3006260740Model number
N/ACatalog number
PIC0220
Lot number
JUEY1044
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 JUEY1044 SHOWED SIX OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER.
Description of Event or Problem
IT WAS REPORTED "RN OPENED PACKAGE AND NOTED PLASTIC SECUREMENT PIECE SEPARATING FROM WING BANDAGE AND BLUE PINS OUT OF PLACE."