BEUDAMED
    FDA Adverse Event Death Summary report: N

    MEDRAD

    MDR report key: 306595 · Received November 21, 2000

    Report

    Report Number
    306595
    Event Type
    Death
    Date Received
    November 21, 2000
    Date of Event
    September 11, 2000
    Report Date
    November 21, 2000
    Manufacturer
    MEDRAD, INC
    Product Code
    IZQ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    BIOMEDICAL ENGINEER

    Narratives

    Description of Event or Problem · 1

    30 CC AIR WAS INJECTED INTO THE LV INSTEAD OF THE CONTRAST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDRAD ANGIOGRAPHY CONTRAST MEDIA POWER INJECTOR IZQ MEDRAD, INC MARK IV NA

    Patients

    Seq Age Sex Outcome Treatment
    1 83 YR Death