MalfunctionFOX
STATLOCK PICC PLUS CRESCENT SLIDING POST
Received Nov 1, 2022 · Event occurred Oct 17, 2022
Report 3006260740-2022-04251 · MDR key 15712549
Device
Generic name
Stand, Infusion
Manufacturer
C.r. Bard, Inc. (basd) -3006260740Model number
N/ACatalog number
PIC0220
Lot number
JUGQ2040
Product problems
- Detachment of Device or Device Component
- Detachment of Device or Device Component
Patient
Unknown
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Additional Manufacturer Narrative
THE DATE OF EVENT WAS NOT PROVIDED BY THE COMPLAINANT/REPORTER, THE DATE REFLECTED IN THIS REPORT IS THE DATE BD BECAME AWARE OF THE EVENT. THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER FOR EVALUATION. A LOT HISTORY REVIEW (LHR) OF JUGQ2040 SHOWED NO OTHER SIMILAR PRODUCT COMPLAINT(S) FROM THIS LOT NUMBER.
Description of Event or Problem
PR 6336126: IT WAS REPORTED BY THE CUSTOMER "VERY EASY FOR IT TO COME APART WITH VERY LITTLE FORCE." NO OTHER INFORMATION WAS PROVIDED.