BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD PORT IMPLANTED PORT WITH GROSHONG CATHETER

    MDR report key: 2003461 · Received February 21, 2011

    Report

    Report Number
    MW5019506
    Event Type
    Injury
    Date Received
    February 21, 2011
    Date of Event
    July 9, 2010
    Report Date
    February 21, 2011
    Manufacturer
    BARD ACCESS SYSTEMS
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT WANTED CATHETER REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD PORT IMPLANTED PORT WITH GROSHONG CATHETER PORTACATH OR GROSHONG LJT BARD ACCESS SYSTEMS RESH1136

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Disability