BEUDAMED
    FDA Adverse Event Summary report: N

    THAL-QUICK CHEST TUBE TRAY

    MDR report key: 3080351 · Received April 22, 2013

    Report

    Report Number
    MW5029913
    Date Received
    April 22, 2013
    Date of Event
    April 17, 2013
    Report Date
    April 22, 2013
    Manufacturer
    COOK INC
    Product Code
    DQR
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING CHEST TUBE INSERTION THE GUIDEWIRE FRACTURED. PATIENT REQUIRED LARGE BORE CHEST TUBE PLACEMENT AS A RESULT GUIDEWIRE REMOVED AND SEQUESTERED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    172294 THAL-QUICK CHEST TUBE TRAY THAL-QUICK CHEST TUBE TRAY DQR COOK INC 4003730

    Patients

    Seq Age Sex Outcome Treatment
    1 85 YR Required Intervention