BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CYLASTIC AXIOM CHEST TUBE

    MDR report key: 24761 · Received July 21, 1995

    Report

    Report Number
    24761
    Event Type
    Injury
    Date Received
    July 21, 1995
    Date of Event
    March 5, 1995
    Report Date
    April 10, 1995
    Manufacturer
    AXIOM MEDICAL, INC.
    Product Code
    KDQ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT UNDERWENT A THORACOTOMY AND CHEST TUBE PLACEMENT ON 3/3/95. ON 3/5/95, DURING REMOVAL ATTEMPTS, THE CHEST TUBE BROKE. SURGICAL RETRIEVAL PERFORMED ON 3/6/95.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CYLASTIC AXIOM CHEST TUBE CHEST TUBE KDQ AXIOM MEDICAL, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 4 YR Required Intervention