BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERHICKMAN

    MDR report key: 3073066 · Received April 18, 2013

    Report

    Report Number
    3073066
    Event Type
    Malfunction
    Date Received
    April 18, 2013
    Date of Event
    October 10, 2012
    Report Date
    April 18, 2013
    Manufacturer
    C. R. BARD INC.
    Product Code
    LJS
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    166886 POWERHICKMAN CATHETER LJS C. R. BARD INC. * REWB1619

    Patients

    Seq Age Sex Outcome Treatment
    1 85 YR