BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PORT A CATH NEEDLE

    MDR report key: 20344404 · Received September 30, 2024

    Report

    Report Number
    MW5160337
    Event Type
    Injury
    Date Received
    September 30, 2024
    Date of Event
    September 20, 2024
    Report Date
    September 25, 2024
    Manufacturer
    C.R. BARD, INC.
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    UNKNOWN
    Health Professional
    *

    Narratives

    Description of Event or Problem · 0

    TUBING CRACKED AND LEAKING NEAR CLAVE PORT A CATH NEEDLE 20G X 0.75 POWER LOC MAX BARD PRODUCT REF: 0142075, LOT: ASHZF C 102.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1870811 PORT A CATH NEEDLE SET, ADMINISTRATION, INTRAVASCULAR FPA C.R. BARD, INC. ASHZF C 102

    Patients

    Seq Age Sex Outcome Treatment
    1 15 MO Female Required Intervention