BEUDAMED
    FDA Adverse Event Injury Summary report: N

    A TRAUM AXIOM ANGLE SILICONE CATHETER

    MDR report key: 10818 · Received December 13, 1993

    Report

    Report Number
    10818
    Event Type
    Injury
    Date Received
    December 13, 1993
    Date of Event
    September 30, 1993
    Report Date
    October 18, 1993
    Manufacturer
    AXIOM MEDICAL, INC.
    Product Code
    KDQ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IN, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    RN WAS REMOVING CHEST TUBE AFTER SURGERY. TUBE BROKE OFF AND APPROX 9 CM REMAINED IN CHEST. PIECE HAD TO BE REMOVED SURGICALLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 A TRAUM AXIOM ANGLE SILICONE CATHETER CHEST TUBE KDQ AXIOM MEDICAL, INC. 28 FRENCH SIX EYES

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Required Intervention