inforMED
MalfunctionFOX

STATLOCK PICC PLUS CRESCENT SLIDING POST

Received Jul 29, 2021 · Event occurred Mar 12, 2021

Report 3006260740-2021-02997 · MDR key 12246906

Device

Generic name

Stand, Infusion

Model number

N/A

Catalog number

PIC0220

Lot number

JUEX1695

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 JUEX1695 SHOWED FIVE OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER.

Description of Event or Problem

IT WAS REPORTED CLIPS THAT SECURE EVERYTHING IN PLACE ARE COMING UNCLIPPED." NO OTHER INFORMATION WAS PROVIDED.