BEUDAMED
    FDA Adverse Event Other Summary report: N

    VITAL PORT

    MDR report key: 12012 · Received March 10, 1994

    Report

    Report Number
    MW1001065
    Event Type
    Other
    Date Received
    March 10, 1994
    Date of Event
    February 16, 1994
    Report Date
    February 18, 1994
    Manufacturer
    COOK PACEMAKER CORP.
    Product Code
    LJT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NC, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE PROCEDURE WAS FOR INSERTION OF PORT AND EXTRACTION OF NONFUNCTIONING PORT. WHILE REMOVING THE NONFUNCTIONING PORT THE EXTRA PORTION OF THE CATHETER WAS SHEARED AND COULD NOT BE VISUALIZED FOR EXTRACTION. THE PORTAL WAS EXTRACTED. X-RAYS WERE DONE FOLLOWING PROCEDURE FOR PLACEMENT OF NEW PORT AND PLACEMENT OF THE ONE THAT WAS DISLODGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VITAL PORT Implant LJT COOK PACEMAKER CORP.

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other