| Brand Name | ARROW ARTERIAL CATHETER KIT: 20 GA X 12 CM |
| Common Device Name | WIRE, GUIDE, CATHETER |
| 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 Key | 25750702 |
| Report Number | 9680794-2026-00512 |
| Device Sequence Number | 10400922 |
| Product Code |
OFB
|
| UDI-Device Identifier | 10801902117929 |
| Combination Product (Y/N) | N |
| Initial Reporter State | NY |
| Initial Reporter Country | US |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
User Facility |
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
06/12/2026 |
| 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 Number | ASK-04100-NS |
| Device Lot Number | 33F26B0667 |
| Was Device Available for Evaluation? |
Yes
|
| Is the Reporter a Health Professional? |
No
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/12/2026 |
| Supplement Date Received by Manufacturer | 07/24/2026
|
| Initial Report FDA Received Date | 07/08/2026 |
| Supplement Report FDA Received Date | 08/10/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Device Not Returned to Manufacturer
|
| Date Device Manufactured | 03/23/2026 |
| 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 |
| Patient Sex | Unknown |
|
|