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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW CVC SET: 2-LUMEN 4 FR X 5 CM; CATHETER PERCUTANEOUS

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ARROW INTERNATIONAL LLC ARROW CVC SET: 2-LUMEN 4 FR X 5 CM; CATHETER PERCUTANEOUS Back to Search Results
Model Number IPN918836
Medical Device Problem Codes Unraveled Material (1664); Physical Resistance/Sticking (4012)
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 during central venous catheter (cvc) placement, the spring wire guide (swg) was unable to advance through the introducer needle into the vein.When the user attempted to withdraw the swg, resistance was encountered, and the guidewire became stuck within the needle.During removal, the swg was observed to stretch.As a result, both the introducer needle and the swg were removed from the patient simultaneously.Following removal from the patient, the swg was successfully separated from the needle without further issue.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 CVC SET: 2-LUMEN 4 FR X 5 CM
Common Device Name
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 Key25627550
Report Number3006425876-2026-00686
Device Sequence Number13310682
Product Code OWL
UDI-Device Identifier10801902184419
UDI-Public(01)10801902184419(11)240529(17)290430(10)71F24E1049(21)
Combination Product (Y/N)N
Initial Reporter CountryFI
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) 06/01/2026
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 Model NumberIPN918836
Device Catalogue NumberCS-12402
Device Lot Number71F24E1049
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/19/2026
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/01/2026
Supplement Date Received by Manufacturer07/06/2026
Initial Report FDA Received Date06/25/2026
Supplement Report FDA Received Date07/16/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/29/2024
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.
Patient SexUnknown
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