BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COVIDIEN/KENDALL

    MDR report key: 1376076 · Received May 5, 2009

    Report

    Report Number
    MW5010994
    Event Type
    Injury
    Date Received
    May 5, 2009
    Date of Event
    April 7, 2009
    Report Date
    May 5, 2009
    Manufacturer
    15 HAMPSHIRE STREET
    Product Code
    MPB
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    A PALINDROME DIALYSIS CATHETER BY COVIDIEN/KENDALL - VASCULAR THERAPY DIVISION- WAS PLACED IN A PT. THE END OF THE CATHETER-LUERLOCK PORTION-CRACKED AND NEEDED AN EXCHANGE. THIS REQUIRED THE PT CO COME IN FOR AN INVASIVE PROCEDURE TO CONTINUE WITH DIALYSIS. DATES OF USE: 2009. DIAGNOSIS -ESRD-.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COVIDIEN/KENDALL PALINDROME SPORT PACK DIALYSIS CATHETER MPB 15 HAMPSHIRE STREET 8888119364 806738

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Disability