BEUDAMED
    FDA Adverse Event Other Summary report: N

    DAIG CORP. ST. JUDE MEDICAL CO.

    MDR report key: 207858 · Received January 25, 1999

    Report

    Report Number
    207858
    Event Type
    Other
    Date Received
    January 25, 1999
    Date of Event
    January 22, 1999
    Report Date
    January 24, 1999
    Manufacturer
    DAIG CORP.
    Product Code
    DYB
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING PLACEMENT OF MEDIPORT, PART OF 10F INTRODUCER SHEARED OFF. PT RETURNED TO OPERATING ROOM FOR REMOVAL AND DID WELL POST-OPERATIVELY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DAIG CORP. ST. JUDE MEDICAL CO. CATHETER DYB DAIG CORP. 68440512013 *

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR Other