BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ON-Q PAIN PUMP

    MDR report key: 1421004 · Received July 21, 2009

    Report

    Report Number
    MW5012087
    Event Type
    Malfunction
    Date Received
    July 21, 2009
    Date of Event
    April 11, 2009
    Report Date
    July 21, 2009
    Manufacturer
    VQ ORTHOCARE
    Product Code
    MEB
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MN, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT UNDERWENT UNEVENTFUL LEFT DONOR NEPHRECTOMY IN 2009. ON-Q PAIN PUMP CATHETER REMOVED TWO DAYS LATER. ON-Q CATHETER SNAPPED ON REMOVAL; A SMALL LENGTH OF THE CATHETER BROKE AND WAS RETAINED IN THE ANTERIOR ABDOMINAL WELL. ATTEMPTED TO IMAGE OBJECT WITH CT AND ULTRASOUND, TOO FINE TO BE IDENTIFIED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ON-Q PAIN PUMP PAIN PUMP CATHETER MEB VQ ORTHOCARE

    Patients

    Seq Age Sex Outcome Treatment
    1 32 YR NONE KNOWN