inforMED
MalfunctionFOX

STATLOCK PICC PLUS SLIDING POST, CRESCENT PAD & SKIN PREP

Received Jun 23, 2021 · Event occurred Jun 1, 2021

Report 3006260740-2021-02420 · MDR key 12050725

Device

Generic name

Stand, Infusion

Catalog number

VPPCSPCE

Lot number

JUEZ0865

Product problems

  • Misconnection
  • Misconnection

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 JUEZ0865 SHOWED ONE OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER. THE COMPLAINTS FOR THIS LOT NUMBER HAVE BEEN REPORTED FROM THE SAME FACILITY IN (B)(4).

Description of Event or Problem

IT WAS REPORTED THE PROBLEM ENCOUNTERED BY THE NURSE: WHEN OPENING THE DRESSING OF THE HICKMANN CATHETER, OPEN FIN - CHANGE OF STATLOCK AND SAME PROBLEM DURING FITTING: THE FIN DOES NOT CLOSE ON THE CATHETER CONSEQUENCE, THE CATHETER MOVES. NO OTHER INFORMATION WAS PROVIDED. IT WAS REPORTED THIS OCCURRED WITH TWO DEVICES. THIS REPORT ADDRESSES THE SECOND DEVICE.