| Brand Name | ARROW EPIDURAL CATHETERIZATION SET |
| Common Device Name | ANESTHESIA CONDUCTION CATHETER |
| 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 |
|
azhwan
barazenda
|
| 3015 carrington mill blvd |
| morrisville, NC 27560
|
|
| MDR Report Key | 25754670 |
| Report Number | 3006425876-2026-00810 |
| Device Sequence Number | 13368809 |
| Product Code |
BSO
|
| UDI-Device Identifier | 10801902197570 |
| UDI-Public | (01)10801902197570(11)260106(17)271231(10)71F25M0643 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | IT |
| PMA/510(K) Number | K140110 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,User Facility |
| Initial Reporter Occupation |
Nurse
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
06/11/2026 |
| 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 Number | IPN920760 |
| Device Catalogue Number | JC-05400-B |
| Device Lot Number | 71F25M0643 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 06/11/2026 |
| Supplement Date Received by Manufacturer | 07/29/2026
|
| 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 | 01/06/2026 |
| 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 |
Concomitant Medical Products and Therapy/Usage Dates | NONE REPORTED. |
| Patient Sex | Unknown |