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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW HEMODIALYSIS SET: 2-LUMEN 12 FR X 16 CM; CATHETER HEMODIALYSIS NON IMPL

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ARROW INTERNATIONAL LLC ARROW HEMODIALYSIS SET: 2-LUMEN 12 FR X 16 CM; CATHETER HEMODIALYSIS NON IMPL Back to Search Results
Catalog Number CU-22122-F
Medical Device Problem Codes Material Twisted/Bent (2981); Physical Resistance/Sticking (4012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/10/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).
 
Event or Problem Description
It was reported that: "the occlusion of the central lumen of ars prevented the guidewire from passing through smoothly, resulting in guidewire deflection.The same issue persisted even after the catheter was replaced, yet the procedure was ultimately completed successfully.The second swg/ars that had resistance but was able to complete the procedure was found kinked.There was no reported patient harm or consequence." associated complaint 3006425876-2026-00050.
 
Additional 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 potential findings were identified; however, as no sample was returned for investigation, it could not be determined if the findings were relevant to the reported event.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.
 
Event or Problem Description
It was reported that: ", the occlusion of the central lumen of ars prevented the guidewire from passing through smoothly, resulting in guidewire deflection.The same issue persisted even after the catheter was replaced, yet the procedure was ultimately completed successfully.The second swg/ars that had resistance but was able to complete the procedure was found kinked.There was no reported patient harm or consequence." associated complaint 3006425876-2026-00108 and 3006425876-2026-00050.
 
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Brand Name
ARROW HEMODIALYSIS SET: 2-LUMEN 12 FR X 16 CM
Common Device Name
CATHETER HEMODIALYSIS NON IMPL
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 Key24143137
Report Number3006425876-2026-00108
Device Sequence Number8998328
Product Code MPB
UDI-Device Identifier00801902100252
UDI-Public(01)00801902100252(11)230206(17)250112(10)71F23A2932(21)
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K993933
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility,Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 12/26/2025
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
Operator of Device Health Professional
Device Expiration Date01/12/2025
Device Catalogue NumberCU-22122-F
Device Lot Number71F23A2932
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 12/26/2025
Supplement Date Received by Manufacturer02/13/2026
Initial Report FDA Received Date01/22/2026
Supplement Report FDA Received Date02/13/2026
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured02/06/2023
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 Number1
Concomitant Medical Products
and Therapy/Usage Dates
NOT REPORTED; NOT REPORTED
Patient SexUnknown
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