BEUDAMED
    FDA Adverse Event Death Summary report: N

    LIFEPORT

    MDR report key: 18683 · Received January 3, 1995

    Report

    Report Number
    MW1004634
    Event Type
    Death
    Date Received
    January 3, 1995
    Date of Event
    December 20, 1994
    Report Date
    December 20, 1994
    Manufacturer
    STRATO MEDICAL CORP.
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TN, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    AFTER AN ALLEGED BEATING BY SPOUSE, PT ENTERED THE HOSP FOR REMOVAL OF THE TIP OF THE CATHETER. DR REMOVED ROUND PORTION AND PART OF CATHETER IN SURGERY 12/20/94. UNKNOWN IF PRODUCT FAILURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFEPORT LIFEPORT CATHETER STRATO MEDICAL CORP.

    Patients

    Seq Age Sex Outcome Treatment
    1 43 YR Other