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U.S. Department of Health and Human Services

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

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ARROW INTERNATIONAL LLC ARROW ARTERIAL CATH SET: 20 GA X 8CM; CATHETER PERCUTANEOUS Back to Search Results
Catalog Number SAC-00820-PBX
Device Problem Material Twisted/Bent (2981)
Patient Problem Insufficient Information (4580)
Event Date 02/13/2024
Event Type  malfunction  
Event Description
It was reported "we observed incident with several dysfunctional arterial catheters that occured either immediately after insertion or few days after insertion." the patient's current condition is reported as "unknown" at this time.An attempt was made to contact the customer to gather additional information; however, no response has been received at the time of this report.
 
Manufacturer Narrative
(b)(4).
 
Event Description
It was reported "we observed incident with several dysfunctional arterial catheters that occured either immediately after insertion or few days after insertion." the patient's current condition is reported as "unknown" at this time.An attempt was made to contact the customer to gather additional information; however, no response has been received at the time of this report.
 
Manufacturer Narrative
(b)(4).Complaint verification testing could not be performed as it was reported that the sample is not available for return.The customer did not provide a lot number; therefore, a device history record review was performed based upon a lot number taken from the sales history data of the customer.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.
 
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Brand Name
ARROW ARTERIAL CATH SET: 20 GA X 8CM
Type of Device
CATHETER PERCUTANEOUS
Manufacturer (Section D)
ARROW INTERNATIONAL LLC
morrisville NC
Manufacturer (Section G)
ARROW INTERNATIONAL CR, A.S.
jamska 2359/47
zdar nad sazavou 591 0 1
EZ   591 01
Manufacturer Contact
katharine tarpley
3015 carrington mill blvd
morrisville, NC 27560
MDR Report Key18968504
MDR Text Key338665626
Report Number3006425876-2024-00305
Device Sequence Number1
Product Code DQY
Combination Product (y/n)N
Reporter Country CodeFR
PMA/PMN Number
K093050
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,User Facility,Distributor
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 03/01/2024
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 Catalogue NumberSAC-00820-PBX
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/01/2024
Initial Date FDA Received03/25/2024
Supplement Dates Manufacturer Received04/18/2024
Supplement Dates FDA Received04/23/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
NONE REPORTED.; NONE REPORTED.
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