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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-SP
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, that an indwelling cannon ii plus chronic hemodialysis catheter (chdc), originally inserted on (b)(6) 2026, exhibited cracking at the luer hub/fitting accompanied by blood oozing from the affected area.There were no reports of patient injury, harm, or adverse health consequences associated with this event.The patient's condition was reported as "fine." the affected catheter was removed and replaced with another device.No additional medical or surgical 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 Key25593705
Report Number9680794-2026-00475
Device Sequence Number12187598
Product Code MSD
UDI-Device Identifier00801902096326
UDI-Public(01)00801902096326(11)240305(17)270228(10)33F24A0271(21)
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K111117
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-SP
Device Lot Number33F24A0271
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 Manufacturer06/29/2026
Initial Report FDA Received Date06/23/2026
Supplement Report FDA Received Date07/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured03/05/2024
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 SexUnknown
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