BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD PORT WITH OPENED-ENDED CATHETER

    MDR report key: 1981128 · Received February 3, 2011

    Report

    Report Number
    1981128
    Event Type
    Injury
    Date Received
    February 3, 2011
    Date of Event
    March 31, 2010
    Report Date
    January 28, 2011
    Manufacturer
    C.R. BARD INC.
    Product Code
    LJT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    BARD PORT PLACED ON (B)(6) 2007. PORT VENOGRAM PERFORMED ON (B)(6) 2010 WITH RESULTS DEMONSTRATING CATHETER TO BE FRACTURED WITH THE DISTAL PIECE LOCATED IN THE RIGHT ATRIUM AND EXTENDED INTO THE LEFT BRACHIO-CEPHALIC VEIN. APPROXIMATELY 3 CM OF CATHETER REMAINED ATTACHED TO THE INFUSAPORT. ON (B)(6) 2010, CATHETER WAS REMOVED IN CATH LAB AT ANOTHER HOSPITAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD PORT WITH OPENED-ENDED CATHETER 0602270 LJT C.R. BARD INC. 0602270 RERH0326

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Hospitalization| R