BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD ACCESS SYSTEM, INC.

    MDR report key: 3066294 · Received April 15, 2013

    Report

    Report Number
    MW5029802
    Event Type
    Injury
    Date Received
    April 15, 2013
    Date of Event
    February 6, 2009
    Report Date
    April 5, 2013
    Manufacturer
    BARD ACCESS SYSTEM, INC.
    Product Code
    LJS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    TRIFUSION PLACEMENT (B)(6) 2008. RETURNED FOR MALFUNCTION (B)(6) 2009. REPLACED CATHETER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    160708 BARD ACCESS SYSTEM, INC. HICKMAN, TRIFUSION LJS BARD ACCESS SYSTEM, INC. * RESF0150

    Patients

    Seq Age Sex Outcome Treatment
    1 30 YR Required Intervention