BEUDAMED
    FDA Adverse Event Other Summary report: N

    AXIOMATRAUM

    MDR report key: 302800 · Received October 25, 2000

    Report

    Report Number
    2020735-2000-00001
    Event Type
    Other
    Date Received
    October 25, 2000
    Date of Event
    September 15, 2000
    Report Date
    September 25, 2000
    Manufacturer
    AXIOM MEDICAL, INC.
    Product Code
    KDQ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PHYSICIAN WAS ATTEMPTING TO REMOVE A STUCK CHEST TUBE. THE PHYSICIAN MANIPULATED THE TUBE AND THE DISTAL END BROKE OFF AND BECAME LODGED IN THE LEFT PLEURAL SPACE. THE PT WAS TAKEN TO SURGERY AND THE TUBING WAS REMOVED WITHOUT COMPLICATIONS. THE PT WAS TRANSFERRED OUT OF THE UNIT THE NEXT DAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AXIOMATRAUM DRAINS, THORACIC KDQ AXIOM MEDICAL, INC. * 0003221

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Required Intervention