BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PHARMACIA DELTEC INC.

    MDR report key: 10210 · Received September 23, 1993

    Report

    Report Number
    10210
    Event Type
    Injury
    Date Received
    September 23, 1993
    Date of Event
    September 20, 1993
    Report Date
    September 22, 1993
    Manufacturer
    PHARMACIA DELTEC, INC.
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT ADMITTED TO OUTPT SURGERY FOR REMOVAL OF VENOUS ACCESS PORT: FILM REVEALED TIP OF CATHETER BROKEN OFF. CONFIRMED BY GROSS PATHOLOGY EXAM. TIP NOT RETRIEVABLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PHARMACIA DELTEC INC. Implant VENOUS ACCESS PORT WITH ATTACHED CATHETER LJT PHARMACIA DELTEC, INC. NI NI

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Hospitalization| R