| Brand Name | ARROW CVC SET: 2-LUMEN 7 FR X 20 CM |
| Common Device Name | CATHETER INTRAVASCULAR THERAPE |
| 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 |
|
angela
meister
|
| 3015 carrington mill blvd |
| morrisville 27560
|
|
| MDR Report Key | 50871783 |
| Report Number | 3006425876-2026-00982 |
| Device Sequence Number | 16124970 |
| Product Code |
FOZ
|
| UDI-Device Identifier | 10801902217551 |
| UDI-Public | (01)10801902217551(11)250818(17)270530(10)71F25H0613 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | CH |
| PMA/510(K) Number | K900263 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,User Facility |
| Type of Report
| Initial |
| Report Date (Section B) |
08/28/2026 |
| 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 Number | CS-27702-E |
| Device Lot Number | 71F25H0613 |
| 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 | 08/28/2026 |
| Initial Report FDA Received Date | 09/23/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Device Not Returned to Manufacturer
|
| Date Device Manufactured | 08/18/2025 |
| 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 | Not Reported. |
| Patient Age | 56 YR |
| Patient Sex | Unknown |