BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LIFEPORT

    MDR report key: 2931763 · Received January 23, 2013

    Report

    Report Number
    2931763
    Event Type
    Malfunction
    Date Received
    January 23, 2013
    Date of Event
    August 23, 2012
    Report Date
    January 23, 2013
    Manufacturer
    ANGIODYNAMICS
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US

    Narratives

    Description of Event or Problem · 1

    THE INTRODUCER THAT COMES IN THE KIT COLLAPSED AND THE CATHETER WOULD NOT GO DOWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    32289 LIFEPORT PORT & CATHETER, IMPLANTED, SUBCUTANEOUS, INTRAVASCULAR LJT ANGIODYNAMICS * 562702

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR