BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIFEPORT VASCULAR ACCESS SYSTEM

    MDR report key: 133659 · Received November 20, 1997

    Report

    Report Number
    1220923-1997-00031
    Event Type
    Injury
    Date Received
    November 20, 1997
    Date of Event
    October 17, 1997
    Product Code
    LJT
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report

    Narratives

    Additional Manufacturer Narrative · 1

    THE EVALUATION RESULTS OF APPARENT TREND FOR SUSPECTED CATHETER LOT HAS BEEN COMPLETED AND THE RESULTS ARE AS FOLLOWS: 1) THE COMPLAINT RATE WAS CONSISTENT WITH COMPLAINT RATES FROM OTHER MFG LOTS. 2) THE PRODUCT PROFILE WAS BIMODAL, BUT BOTH ARMS OF THE MODALITY WERE WITHIN THE PRODUCT SPEC. 3) MATERIAL ID AND FUNCTION WERE CONSISTENT WITH 510K AND COMPANY SPECS. 4) SHEARED CATHETERS RETURNED WERE REVIEWED AND FOUND TO HAVE THE "PINCH-OFF" INDICATION. THE COMPLETE FILE OF THIS APPARENT TREND WAS REVIEWED BY A FOOD AND DRUG ADMINISTRATION INVESTIGATOR DURING AN ATLANTA DISTRICT OFFICE AUDIT OF THE MFR WHICH WAS CONDUCTED FROM 8/24/98 THROUGH 9/15/98. NO FURTHER DETAILS ARE AVAILABLE. THE MFR IS NOW CLOSING THE FILE ON THIS EVENT. THE FILING OF THIS 02 FOLLOW-UP REPORT WILL ALSO SERVE TO CLOSE THE FOLLOWING MDR#'S LISTED OF THE SAME NATURE: MDR#1219454-1997-00249, 00299, 00314, 00237; MDR#1220923-1997-0007, 00015, 00016, 00017, 00025, 00031, 00032, 00033, 00034, 00041, 00044; MDR#1220923-1998-00014, 00024, 00029, 00038, 000045, 00050, 00071.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFEPORT VASCULAR ACCESS SYSTEM Implant VASCULAR ACCESS DEVICE LJT NA

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention