BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HORIZON MEDICAL PRODUCTS, INC.

    MDR report key: 300360 · Received October 11, 2000

    Report

    Report Number
    MW1020156
    Event Type
    Injury
    Date Received
    October 11, 2000
    Date of Event
    October 3, 2000
    Report Date
    October 11, 2000
    Manufacturer
    HORIZON MED. PRODUCTS, INC.
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PORT-A-CATH BROKE AND LODGED ITSELF IN PT'S HEART.

    Description of Event or Problem · 1

    ADD'L INFO REC'D 10/23/00: AGE OF DEVICE: 6 MOS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HORIZON MEDICAL PRODUCTS, INC. LIFE PORT LJT HORIZON MED. PRODUCTS, INC. 7013 14899

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Life Threatening