BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD

    MDR report key: 2228454 · Received November 8, 2007

    Report

    Report Number
    MW5021911
    Event Type
    Injury
    Date Received
    November 8, 2007
    Date of Event
    October 31, 2007
    Report Date
    November 6, 2007
    Manufacturer
    BARD
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    UPON REMOVAL PORTA-CATH, PORT WAS NOT CONNECTED TO PORT REMOVED IN INTERVENTIONAL RAD. "TUBING NOT INTACT ON PORT."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD BARD PORT IMPLANTABLE PORT LJT BARD UNSURE

    Patients

    Seq Age Sex Outcome Treatment
    1 46 YR Required Intervention