BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD

    MDR report key: 1133443 · Received June 9, 2008

    Report

    Report Number
    1133443
    Event Type
    Injury
    Date Received
    June 9, 2008
    Date of Event
    June 6, 2008
    Report Date
    June 9, 2008
    Manufacturer
    C.R. BARD, INC.
    Product Code
    LJT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    OK, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    BARDPORT IMPLANTED IN 2008. NONFUNCTIONING PORT, HERE FOR REMOVAL OF PORT AT ABOUT APPROX 21 DAYS LATER. DURING REMOVAL, THE PORT AND ONLY A PORTION OF THE CATHETER WAS REMOVED. THE REMAINING PIECE WAS VISUALIZED IN THE INTERNAL JUGULAR BY C-ARM. INTERVENTIONAL RADIOLOGIST SUCCESSFULLY REMOVED THE REMAINING PIECE (HALF THE CATHETER) THROUGH THE RIGHT FEMORAL VEIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD BARD PORT 9.6 LJT C.R. BARD, INC. 9.6 RESA0806

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR Required Intervention CHEMOTHERAPY