BEUDAMED
    FDA Adverse Event Other Summary report: N

    G2 X

    MDR report key: 1564800 · Received December 21, 2009

    Report

    Report Number
    MW5014070
    Event Type
    Other
    Date Received
    December 21, 2009
    Date of Event
    December 16, 2009
    Report Date
    December 16, 2009
    Manufacturer
    BAND PERIPHERAL VASCULAR INC.
    Product Code
    DTK
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PHYSICIAN DEPLOYED G2X VENA CAVA FILTER AND UPON VISUALIZATION, IT WAS OUTSIDE VENA CAVA. DEVICE LEFT IN PLACE, AND 2ND FILTER DEPLOYED WITHOUT ISSUE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 G2 X VENA CAVA FILTER DTK BAND PERIPHERAL VASCULAR INC. GF162545

    Patients

    Seq Age Sex Outcome Treatment
    1