BEUDAMED
    FDA Adverse Event Injury Summary report: N

    IDEAS PORT

    MDR report key: 22611 · Received March 14, 1995

    Report

    Report Number
    1033972-1995-00001
    Event Type
    Injury
    Date Received
    March 14, 1995
    Date of Event
    January 26, 1995
    Report Date
    February 7, 1995
    Manufacturer
    IDEAS FOR MEDICINE
    Product Code
    MFC
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ONCOLOGIST COULD NOT GET A RETURN; CATHETER DISCONNECT AT BASE OF PORT. PT SCHEDULED FOR REMOVAL OF PORT ON 1/26/95.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 IDEAS PORT Implant VASCULAR ACCESS DEVICE MFC IDEAS FOR MEDICINE IP2001 D082794-21

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention