InjuryJCY
5F DUAL VASCU - PICC
Received Oct 2, 2014 · Event occurred Aug 22, 2014
Report 2518902-2014-00063 · MDR key 4142701
Device
Generic name
Infusion Catheter
Manufacturer
MedcompModel number
MR17015206Catalog number
MR17015206
Lot number
MBSX660
Product problems
- Occlusion Within Device
Patient
78 YR
- Swelling
- Thrombosis
Narrative
Additional Manufacturer Narrative
AN INVESTIGATION HAS BEEN INITIATED. WHEN THE INVESTIGATION IS COMPLETE A SUPPLEMENTAL REPORT WILL BE SUBMITTED.
Description of Event or Problem
STAFF NURSE NOTED SWELLING TO THE EXTREMITY WHERE THE PICC LINE WAS INSERTED. THE PICC LINE WAS REMOVED AND AN ULTRASOUND WAS ORDERED BY THE MD. ULTRASOUND REVEALS NON OCCLUSIVE THROMBOSIS OF THE BRACHIAL VEIN.