FDA Adverse Event
Injury
Summary report: N
XCELA
MDR report key: 23839928
·
Received December 18, 2025
Report
- Report Number
- 3008797795-2025-00044
- Event Type
- Injury
- Date Received
- December 18, 2025
- Date of Event
- January 6, 2023
- Report Date
- December 17, 2025
- Manufacturer
- PFM MEDICAL CPP SA
- Product Code
- LJT
- PMA / PMN Number
- K072481
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- US
- Reporter Occupation
- 003
Narratives
Additional Manufacturer Narrative · 0
THE MANUFACTURER CONDUCTED A DOCUMENTARY REVIEW OF RISK ANALYSIS. WITHOUT RETURNED PRODUCT AND REFERENCE/BATCH NUMBER, IT IS NOT POSSIBLE ADDITIONAL DOCUMENTARY REVIEW AND TO CONFIRM THE REPORTED DEFECT. THE RELATED RISKS ARE IDENTIFIED IN OUR RISK MANAGEMENT FILE AND PROCEDURE CLEARLY DESCRIBED IN THE IFU. THEREFORE, COMPLAINT IS CLASSIFIED AS NO DEFINITIVE CONCLUSION, UNVERIFIABLE (NO RETURN PRODUCT).
Description of Event or Problem · 0
PORT WAS IMPLANTED ON (B)(6) 2022 FOR THE PURPOSE OF CHEMOTHERAPY DELIVERY. THROMBOSIS IN OR AROUND THE CATHETER WAS DIAGNOSED ON (B)(6) 2023. THE PORT WAS REMOVED ON (B)(6) 2023.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2244547 | XCELA | PORT | LJT | PFM MEDICAL CPP SA | 150639000 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Unknown | Required Intervention| L |