BEUDAMED
    FDA Adverse Event Other Summary report: N

    PORT-A-CATH

    MDR report key: 16742 · Received August 11, 1994

    Report

    Report Number
    16742
    Event Type
    Other
    Date Received
    August 11, 1994
    Date of Event
    May 12, 1994
    Report Date
    May 17, 1994
    Manufacturer
    PHARMACIA DELTECH, INC.
    Product Code
    LJT
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MI, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    PORT-A-CATH INSERTED 2/18/94, BECAME CLOGGED BY CLOTS/DEBRIS. COULD NOT BE IRRIGATED. NECESSITATED REPLACEMENT BY OUTPATIENT SURGERY ON MAY 12, 1994.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PORT-A-CATH Implant CATHETER LJT PHARMACIA DELTECH, INC. UNKNOWN 21056

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Other