BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIFE PORT

    MDR report key: 174543 · Received June 26, 1998

    Report

    Report Number
    174543
    Event Type
    Injury
    Date Received
    June 26, 1998
    Date of Event
    May 21, 1998
    Report Date
    May 29, 1998
    Manufacturer
    HORIZON MEDICAL PROD
    Product Code
    LJT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    UT, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    WHEN REMOVING CATHETER, ONLY 10 CM WAS ATTACHED TO THE HUB. X-RAY REVEALED 20 CM IN RT VENTRICLE. REVIEW OF PREVIOUS X-RAYS SHOW THAT IT HAS BEEN IN VENTRICLE SINCE AT LEAST SEPT. PT REPORTS THAT IT WAS ONLY FUNCTIONAL FOR A COUPLE OF CHEMO INJECTIONS. THEN A PERIPHERATLY INSERTED CENTRAL CATHETER LINE WAS INSERTED FOR REMAINDER OF CHEMO TREATMENTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFE PORT Implant PLASTIC PORT VENOUS ACCESS LJT HORIZON MEDICAL PROD * 13913

    Patients

    Seq Age Sex Outcome Treatment
    1 * Hospitalization| L| R