MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW CVC SET: 3-LUMEN 7 FR X 20 CM; CATHETER INTRAVASCULAR THERAPE

Model Number	IPN928999
Medical Device Problem Code	Material Twisted/Bent (2981)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	12/09/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Qn: (b)(4).
Event or Problem Description
It was reported that "the insertion needles bent (using four different sets from the same batch) during puncture of the right jugular vein.The fourth needle even broke.There were no serious complications for the patient." there was no medical intervention required.The patient's current condition is reported as "fine".Associated mdr numbers include: 3006425876-2026-00056, 3006425876-2026-00057, and 3006425876-2026-00059.
Additional Manufacturer Narrative
(b)(4).The actual device was not returned; however, the customer provided three photos for analysis.The complaint was able to be confirmed by the photos.Three introducer needle/ars assemblies were pictured.All introducer needles had bends in the needle cannula.Signs of use in the form of biological material was observed.It was noted that all three of the samples were from the same lot number (71f25k0352).A device history record review was performed, and no relevant findings were identified.The instructions for use (ifu) provided with this kit warns the user, "do not use excessive force when introducing guidewire or tissue dilator as this can lead to vessel perforation, bleeding, or component damage".The customer report of a bent needle was confirmed by visual inspection of the customer-supplied photos.The images show a needle with a bend in the cannula.Based on the report, images, and the evidence of use in the photos, the root cause cannot be determined.A non-conformance was initiated to further investigate this issue.Teleflex will continue to monitor and trend for reports of this nature.
Event or Problem Description
It was reported that "the insertion needles bent (using four different sets from the same batch) during puncture of the right jugular vein.The fourth needle even broke.There were no serious complications for the patient." there was no medical intervention required.The patient's current condition is reported as "fine".Associated mdr numbers include: 3006425876-2026-00056, 3006425876-2026-00057, 3006425876-2026-00058, and 3006425876-2026-00059.

• Brand Name: ARROW CVC SET: 3-LUMEN 7 FR X 20 CM
• Common Device Name: CATHETER INTRAVASCULAR THERAPE
• 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 Key: 23988684
• Report Number: 3006425876-2026-00058
• Device Sequence Number: 4630815
• Product Code: FOZ
• UDI-Device Identifier: 00801902102324
• UDI-Public: (01)00801902102324(11)251016(17)270925(10)71F25K0352(21)
• Combination Product (Y/N): N
• Initial Reporter Country: BE
• PMA/510(K) Number: K900263
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,User Facility,Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 12/10/2025

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 Model Number: IPN928999
• Device Catalogue Number: CS-25703-E
• Device Lot Number: 71F25K0352
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 12/10/2025
• Supplement Date Received by Manufacturer: 02/27/2026
• Initial Report FDA Received Date: 01/07/2026
• Supplement Report FDA Received Date: 03/03/2026
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• Date Device Manufactured: 10/16/2025
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: NOT REPORTED.; NOT REPORTED.
• Patient Sex: Unknown