| Brand Name | ARROW ARTERIAL CATH. SET: 24 GA X 2.5CM |
| 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 Key | 50422497 |
| Report Number | 3006425876-2026-00912 |
| Device Sequence Number | 16053636 |
| Product Code |
DQY
|
| UDI-Device Identifier | 10801902196917 |
| UDI-Public | (01)10801902196917(11)240930(17)290228(10)71F24J1071 |
| Combination Product (Y/N) | N |
| Initial Reporter State | CA |
| Initial Reporter Country | US |
| PMA/510(K) Number | K171146 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
User Facility,Company Representative |
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
07/27/2026 |
| 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 | SAC-00324-PBX |
| Device Lot Number | 71F24J1071 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 07/27/2026 |
| Supplement Date Received by Manufacturer | 09/09/2026
|
| Initial Report FDA Received Date | 08/25/2026 |
| Supplement Report FDA Received Date | 09/23/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Device Not Returned to Manufacturer
|
| Date Device Manufactured | 09/30/2024 |
| 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 Number | 1 |
| Patient Sex | Unknown |