BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CHEMO SITE

    MDR report key: 117676 · Received June 27, 1997

    Report

    Report Number
    117676
    Event Type
    Injury
    Date Received
    June 27, 1997
    Date of Event
    May 23, 1997
    Report Date
    May 29, 1997
    Manufacturer
    AUTO SUTURE DIV. OF US SURG
    Product Code
    LJT
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    FOLLOWING REMOVAL OF PORT, CATHETER WAS NOTED TO BE SHORT. PORT HAD BEEN NON-FUNCTIONAL AND WAS BEING REMOVED FOR THAT REASON. CHEST X-RAY REVEALED REMAINDER OF CATHETER IN RT SVC, RT ATRIUM, AND RT VENTRICLE. PT WAS TRANSFERRED TO ANOTHER FACILITY FOR REMOVAL OF CATHETER REMNANT IN INTERVENTIONAL RADIOLOGY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CHEMO SITE Implant IMPLANTED VASCULAR ACCESS DEVICE LJT AUTO SUTURE DIV. OF US SURG * AUTO SUTURE REP.

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Required Intervention