BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD PORT IMPLANT PORT WITH GROSHONG CATHETER

    MDR report key: 252199 · Received November 22, 1999

    Report

    Report Number
    252199
    Event Type
    Injury
    Date Received
    November 22, 1999
    Report Date
    November 19, 1999
    Manufacturer
    C.R. BARD, INC.
    Product Code
    LJT
    Report Source
    User Facility report
    Reporter Location
    NH, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    BARD PORT CATHETER INSERTED 1/25/1999. POST PROCEDURE X-RAY SHOWED CATHETER IN POSITION AND INTACT. PT X-RAYED BY ONCOLOGIST TO ASSESS DISEASE STATE ON 11/4/1999. CHEST X-RAY DEMONSTRATED THAT PART OF THE CATHETER HAD BROKEN OFF AND MOVED OUT OF POSITION INTO RIGHT PULMONARY ARTERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD PORT IMPLANT PORT WITH GROSHONG CATHETER Implant IMPLANTABLE IV ACCESS CATHETER LJT C.R. BARD, INC. * 36111370

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Required Intervention PULMONARY ARTERY AT ANOTHER FACILITY.| PART OF CATHETER - DISTAL 4-5 CM REMOVED FROM RT