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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM; CATHETER, HEMODIALYSIS, IMPLA

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ARROW INTERNATIONAL LLC ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM; CATHETER, HEMODIALYSIS, IMPLA Back to Search Results
Catalog Number CS-15242-VSP
Medical Device Problem Codes Crack (1135); Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/28/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).
 
Event or Problem Description
It was reported that on (b)(6) 2026, during use of a cannon ii plus retrograde chronic hemodialysis catheter (chdc), it was observed that there were cracks and blood oozing from the connector.The catheter had originally been inserted on (b)(6) 2026.The affected device was removed and replaced with another device, which functioned as expected.There were no reports of patient injury, harm, or adverse health consequences associated with this event.The patient's condition was reported as "fine." no additional medical intervention was required.
 
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Brand Name
ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM
Common Device Name
CATHETER, HEMODIALYSIS, IMPLA
Manufacturer (Section D)
ARROW INTERNATIONAL LLC
morrisville NC
Manufacturer (Section G)
ARROW INTERNATIONAL DE MEXICO S.A. DE C.V.
ave. washington 3701
colonia panamericana, chihuahua
chihuahua 31200
MX   31200
Manufacturer Contact
katharine tarpley
3015 carrington mill blvd
morrisville, NC 27560
MDR Report Key25586311
Report Number9680794-2026-00471
Device Sequence Number14798017
Product Code PPO
UDI-Device Identifier10801902154221
UDI-Public(01)10801902154221(11)241220(17)271130(10)33F24M0039(21)
Combination Product (Y/N)N
Initial Reporter CountryCH
Number of Events Summarized1
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) 05/28/2026
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 Catalogue NumberCS-15242-VSP
Device Lot Number33F24M0039
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/09/2026
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/28/2026
Supplement Date Received by Manufacturer06/23/2026
Initial Report FDA Received Date06/22/2026
Supplement Report FDA Received Date07/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/20/2024
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 Age85 YR
Patient SexUnknown
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