FDA Adverse Event
Injury
Summary report: N
0600620-HICKMAN 12.0FR. RDL & PI
MDR report key: 284600
·
Received June 27, 2000
Report
- Report Number
- 1720496-2000-00460
- Event Type
- Injury
- Date Received
- June 27, 2000
- Date of Event
- March 22, 2000
- Report Date
- May 19, 2000
- Manufacturer
- C.R. BARD, INC. (PUERTO RICO)
- Product Code
- DQO
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- ATTORNEY
Narratives
Description of Event or Problem · 1
PLACED IN 1999. IT WAS DISCOVERED TO BE LEAKING ON OR ABOUT MARCH 22, 2000. AFTER REMOVAL, IT WAS DISCOVERED THAT THE CATHETER HAD BROKEN. FURTHER SURGERY WAS NECESSARY TO RETRIEVE THE BROKEN CATHETER. NO OTHER INFO PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | 0600620-HICKMAN 12.0FR. RDL & PI | LONG TERM INTRAVASCULAR CATHETER | DQO | C.R. BARD, INC. (PUERTO RICO) | 0600620 | 43BKP002 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNKNOWN | Required Intervention |