BEUDAMED
    FDA Adverse Event Injury Summary report: N

    JACKSON-PRATT

    MDR report key: 2123403 · Received December 5, 2008

    Report

    Report Number
    2123403
    Event Type
    Injury
    Date Received
    December 5, 2008
    Date of Event
    July 20, 2008
    Report Date
    December 4, 2008
    Manufacturer
    CARDINAL HEALTH
    Product Code
    GCY
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MI, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    JACKSON PRATT DRAIN WAS PLACED AFTER AN ACUTE APPENDICITIS WAS RESECTED. TWO DAYS LATER THE J.P. DRAINAGE WAS DECREASING AND THE JP DRAIN WAS REMOVED, BUT THE J.P. DRAIN FRACTURED, NECESSITATING BRINGING THE PATIENT BACK TO THE OPERATING ROOM TO RETRIEVE THE INTRA ABDOMINAL PORTION OF THE DRAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JACKSON-PRATT NONE GCY CARDINAL HEALTH SU130-0323

    Patients

    Seq Age Sex Outcome Treatment
    1 27 YR Required Intervention