BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    19 FRENCH ROUND FLUTED JP DRAIN

    MDR report key: 18096732 · Received November 7, 2023

    Report

    Report Number
    MW5147937
    Event Type
    Malfunction
    Date Received
    November 7, 2023
    Date of Event
    September 29, 2023
    Report Date
    October 24, 2023
    Manufacturer
    C.R. BARD, INC.
    Product Code
    GBX
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    RISK MANAGER
    Health Professional
    Yes

    Narratives

    Description of Event or Problem · 0

    BARD MEDICAL 19 FRENCH FLUTED SILICON JP DRAIN, PART #072190, BROKE OFF DURING ATTEMPTED REMOVAL AND SILICON TIP OF DRAIN WAS RETAINED INSIDE THE PATIENT. POSSIBLE LOT #S: NGGN2906, NGGZ2612, NGGV0936.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1805364 19 FRENCH ROUND FLUTED JP DRAIN CATHETER, IRRIGATION GBX C.R. BARD, INC. NGGN2906

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Female Other