inforMED
MalfunctionFOX

STATLOCK SLIDING POST TRICOT CRESCENT PAD INCLUDES SKIN PREP

Received May 13, 2021 · Event occurred Apr 22, 2021

Report 3006260740-2021-01829 · MDR key 11819999

Device

Generic name

Stand, Infusion

Catalog number

PIC0220CE

Lot number

JUEV0697

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 JUEV0697 SHOWED TWO OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER. THE COMPLAINTS FOR THIS LOT NUMBER HAVE BEEN REPORTED FROM THE SAME FACILITY IN (B)(6).

Description of Event or Problem

IT WAS REPORTED BY FACILITY STAFF "OUR DIALYSIS CENTRE INFORMS US THAT DURING A DRESSING CHANGE OF THE DIALYSIS CATHETER IT WAS NOTICED THAT THE STATLOCK PICC PLUS WAS NO LONGER INTACT. AS THE STATLOCK IS APPLIED AS AN ADDITIONAL SAFETY MEASURE TO KEEP THE DIALYSIS CATHETER IN PLACE, THIS SAFETY MEASURE WAS NOT APPLICABLE HERE. WHEN THE DRESSING WAS REMOVED, THE PLASTIC HOLDER WAS NO LONGER ATTACHED TO THE ADHESIVE PATCH THAT ADHERES TO THE PATIENT'S SKIN. AFTER CARE OF THE DIALYSIS CATHETER, A NEW STATLOCK WAS APPLIED, BUT EVEN WITH THIS (AND THE 3RD ATTEMPT) IT WAS FOUND THAT THE PLASTIC HOLDER DETACHES VERY EASILY FROM THE ADHESIVE PATCH TO WHICH IT IS ATTACHED." THIS REPORT ADDRESSES THE SECOND OF THREE DEVICES.