BEUDAMED
    FDA Adverse Event Injury Summary report: N

    IMPLANTED PORT

    MDR report key: 19149 · Received January 25, 1995

    Report

    Report Number
    MW1004858
    Event Type
    Injury
    Date Received
    January 25, 1995
    Date of Event
    December 28, 1994
    Report Date
    January 6, 1995
    Manufacturer
    NORFOLK MEDICAL PRODUCTS, INC.
    Product Code
    LJT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PRESENTED ON 12/28/94 FOR ELECTIVE REMOVAL OF CATHETER. UPON REMOVAL, CATHETER WAS NOTED TO BE SHORTER THAN NORMAL. CATHETER FRAGMENT REMOVED PERCUTANEOUSLY VIA RIGHT JUGLAR APPROACH. PT DISCHARGED HOME 12/29/94 IN SATISFACTORY CONDITION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 IMPLANTED PORT LJT NORFOLK MEDICAL PRODUCTS, INC. M311GG199

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Hospitalization| R