BEUDAMED
    FDA Adverse Event Other Summary report: N

    DOME SUBCUTANEOUS PORT WITH GROSHONG CATHETER

    MDR report key: 14645 · Received July 13, 1994

    Report

    Report Number
    MW1002793
    Event Type
    Other
    Date Received
    July 13, 1994
    Date of Event
    May 23, 1994
    Report Date
    June 24, 1994
    Manufacturer
    BARD ACCESS SYSTEMS, INC.
    Product Code
    LJT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Description of Event or Problem · 1

    A CATHETER WAS INSERTED IN PT ON 2/4/94. UPON REMOVAL CATHETER WAS NOTED TO BE BROKEN OFF APPROX 4 INCHES. WHEN REVIEWING X-RAYS PREVIOUSLY TAKEN, THE BROKEN PORTION IS NOTED TO BE IN THE LUNG. IT WAS INITIALLY PLACED IN THE RIGHT SUBCLAVIAN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DOME SUBCUTANEOUS PORT WITH GROSHONG CATHETER Implant LJT BARD ACCESS SYSTEMS, INC. UNKNOWN 36JD5459

    Patients

    Seq Age Sex Outcome Treatment
    1 65 YR Other