BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PORT-A-CATH

    MDR report key: 11095 · Received January 28, 1994

    Report

    Report Number
    MW1000514
    Event Type
    Injury
    Date Received
    January 28, 1994
    Date of Event
    December 16, 1993
    Report Date
    December 20, 1993
    Manufacturer
    PHARMACIA DELTEC, INC.
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NE, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    CATHETER BROKE IN HALF AND MIGRATED INTO RIGHT HEART.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PORT-A-CATH Implant LJT PHARMACIA DELTEC, INC. 20547A

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR Required Intervention