BEUDAMED
    FDA Adverse Event Injury Summary report: N

    LIFEPORT CATHETER

    MDR report key: 283222 · Received June 22, 2000

    Report

    Report Number
    283222
    Event Type
    Injury
    Date Received
    June 22, 2000
    Date of Event
    February 9, 2000
    Report Date
    June 20, 2000
    Manufacturer
    HORIZON MEDICAL PROD.
    Product Code
    LJT
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    GA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT WITH PLACEMENT OF LIFEPORT CATHETER IN 1999 FOR ADMINISTRATION OF CHEMOTHERAPY. UNABLE TO ASPIRATE; RADIOLOGY EXAM SHOWED FRACTURED TIP AND MIGRATION TO AN INTRACARDIAC LOCATION. REMOVAL OF CATHETER IN 2000 UNDER RADIOLOGICAL GUIDANCE WITH FLUOROSCOPY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFEPORT CATHETER PORT-A-CATH LJT HORIZON MEDICAL PROD. NA 14730

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Required Intervention