BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TITAN PORT

    MDR report key: 194268 · Received October 21, 1998

    Report

    Report Number
    MW1014835
    Event Type
    Injury
    Date Received
    October 21, 1998
    Date of Event
    October 14, 1998
    Report Date
    October 20, 1998
    Manufacturer
    NORFOLK MEDICAL PRODUCTS, INC.
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT CAME TO HOSP FOR REMOVAL OF THE PORT DUE TO THROMBOSIS. WHEN THE PORT WAS REMOVED THE PHYSICIAN NOTED THAT A PORTION OF THE CATHETER WAS MISSING. PRE-OPERATIVE AND POST-OPERATIVE X-RAYS SHOW THE MISSING PORTION OF THE CATHETER TO BE IN THE HEART.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TITAN PORT Implant INFUSION PORT LJT NORFOLK MEDICAL PRODUCTS, INC. P4355 971101

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Required Intervention