BEUDAMED
    FDA Adverse Event Death Summary report: N

    KENDALL

    MDR report key: 289558 · Received August 9, 2000

    Report

    Report Number
    289558
    Event Type
    Death
    Date Received
    August 9, 2000
    Date of Event
    July 27, 2000
    Report Date
    August 8, 2000
    Manufacturer
    THE KENDALL CO.
    Product Code
    LFJ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    MO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    WHILE PLACING QUINTON CATHETER FOR DIALYSIS AND ON THE SECOND PASS OF THE NEEDLE, THE VEIN APPEARED TO BE CANNULATED, AS THE QUIDEWIRE WOULD NOT PASS. THE PT BEGAN TO COMPLAIN OF PAIN IN THE RIGHT SHOULDER AND THE ENTIRE NEEDLE APPARATUS WAS REMOVED. A HEMATOMA FORMATION WAS NOTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 KENDALL QUINTON CATHETER LFJ THE KENDALL CO. 101289 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 43 YR Death