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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL INC. ARROW ARTERIAL CATH. SET: 20 GA X 8CM; CATHETER PERCUTANEOUS

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ARROW INTERNATIONAL INC. ARROW ARTERIAL CATH. SET: 20 GA X 8CM; CATHETER PERCUTANEOUS Back to Search Results
Model Number IPN037640
Device Problem Obstruction of Flow (2423)
Patient Problem Thrombosis/Thrombus (4440)
Event Date 06/03/2021
Event Type  malfunction  
Manufacturer Narrative
Qn# (b)(4).
 
Event Description
Customer complaint reports "the catheter gets blocked quickly, within 48 hours.So we can't performed blood sample then.And we have to replace the catheter quicker than previously.It was reported the patient had a bilateral radial artery thrombosis following a catheter insertion.Patient had a right radial catheter that was "dysfunctional" 1 day after insertion (captured in 3006425876-2021-00655) and was replaced with catheter in left radial site.Clinician performed seal test, flushing, rinsing the device with a syringe and checking the back pressure on the line.Device ultimately replaced with new catheter.Customer concerned with risk for vascular injury and reports "it can be considered that the repeated aggression of the vascular endothelium by an intravascular device leads to an increase in the risk of thrombosis and can be involved in a thrombosis occurrence.".
 
Event Description
Customer complaint reports "the catheter gets blocked quickly, within 48 hours.So we can't performed blood sample then.And we have to replace the catheter quicker than previously.".It was reported the patient had a bilateral radial artery thrombosis following a catheter insertion.Patient had a right radial catheter that was "dysfunctional" 1 day after insertion (captured in 3006425876-2021-00655) and was replaced with catheter in left radial site.Clinician performed seal test, flushing, rinsing the device with a syringe and checking the back pressure on the line.Device ultimately replaced with new catheter.Customer concerned with risk for vascular injury and reports "it can be considered that the repeated aggression of the vascular endothelium by an intravascular device leads to an increase in the risk of thrombosis and can be involved in a thrombosis occurrence.".
 
Manufacturer Narrative
(b)(4).Complaint verification testing could not be performed as it was reported that the sample is not available for return.A device history record review was performed and no relevant findings were identified.Without the device to evaluate the complaint could not be confirmed and the probable cause could not be determined from the available information.Teleflex will continue to monitor and trend for reports of this nature.Corrected data: section g.2.-report source corrected.
 
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Brand Name
ARROW ARTERIAL CATH. SET: 20 GA X 8CM
Type of Device
CATHETER PERCUTANEOUS
Manufacturer (Section D)
ARROW INTERNATIONAL INC.
reading PA
MDR Report Key12205588
MDR Text Key262953880
Report Number3006425876-2021-00663
Device Sequence Number1
Product Code DQY
Combination Product (y/n)N
PMA/PMN Number
K093050
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,distri
Type of Report Initial,Followup
Report Date 07/06/2021
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberIPN037640
Device Catalogue NumberSAC-00820-PBX
Device Lot Number71F21B0599
Was Device Available for Evaluation? No
Initial Date Manufacturer Received 07/06/2021
Initial Date FDA Received07/21/2021
Supplement Dates Manufacturer Received08/24/2021
Supplement Dates FDA Received08/25/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Treatment
NOT REPORTED; NOT REPORTED
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