BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ALLEGIANCE HEALTHCARE CORP.

    MDR report key: 252140 · Received December 1, 1999

    Report

    Report Number
    252140
    Event Type
    Injury
    Date Received
    December 1, 1999
    Date of Event
    October 31, 1999
    Report Date
    November 9, 1999
    Manufacturer
    ALLEGIANCE HEALTHCARE CORP.
    Product Code
    GBX
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    DURING REMOVAL OF DRAIN TUBING, DRAIN TUBING BROKE LEAVING PART OF TUBING INSIDE PT. SURGERY WAS REQUIRED TO REMOVE BROKEN PIECE OF DRAIN TUBING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALLEGIANCE HEALTHCARE CORP. Implant JACKSON-PRATT DRAIN GBX ALLEGIANCE HEALTHCARE CORP. HEMADUCT GOLD 1990944

    Patients

    Seq Age Sex Outcome Treatment
    1 26 MO Required Intervention