BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COOK SPECTRUM CENTRAL VENOUS TRAY

    MDR report key: 2053028 · Received April 8, 2011

    Report

    Report Number
    MW5020226
    Event Type
    Injury
    Date Received
    April 8, 2011
    Date of Event
    February 28, 2001
    Report Date
    March 22, 2011
    Manufacturer
    COOK MEDICAL INC.
    Product Code
    FOZ
    Report Source
    Voluntary report
    Reporter Location
    DE, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    CENTRAL LINE PLACED. CHEST X-RAY REVEALED GUIDE WIRE EXTENDING FROM SUPERIOR VENA CAVA INTO RIGHT ATRIUM. GUIDE WIRE RETRIEVED IN INTERVENTIONAL RADIOLOGY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COOK SPECTRUM CENTRAL VENOUS TRAY CENTRAL LINE FOZ COOK MEDICAL INC. C-UTLMY-701J-CUSTOM-0005 2655895

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Required Intervention