BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PORT-A-CATH

    MDR report key: 16293 · Received February 4, 1994

    Report

    Report Number
    16293
    Event Type
    Injury
    Date Received
    February 4, 1994
    Date of Event
    November 16, 1993
    Report Date
    November 19, 1993
    Manufacturer
    PHARMACIA DELTEC, INC.
    Product Code
    LJT
    Report Source
    User Facility report
    Reporter Location
    NC, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PATIENT ADMITTED ON 11/16/93 FOR ARTERIOGRAM TO RETRIEVE A CATHETER FRAGMENT. FRAGEMENT WAS SUCCESSFULLY RETRIEVED FROM THE RIGHT VENTRICLE. PATIENT HAD SOME VENTRICULAR TACHYCARDIA DURING PROCEDURE. CATHETER WAS REMOVED THROUGH THE RIGHT FEMORAL VEIN BY A RADIOLOGIST.FOLLOW-UPPATIENT RETURNED ON 12/1/93 FOR REMOVAL OF THE REST OF THE PORTACATH. THIS REMOVAL WAS SUCCESSFUL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PORT-A-CATH Implant VENOUS ACCESS CATHETER LJT PHARMACIA DELTEC, INC. PORTAL PART NO. 69-1944 PORT-8987 CATH-8104

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Hospitalization| R