BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD-Q-CATH

    MDR report key: 335121 · Received May 21, 2001

    Report

    Report Number
    335121
    Event Type
    Injury
    Date Received
    May 21, 2001
    Date of Event
    April 24, 2001
    Report Date
    May 2, 2001
    Manufacturer
    BARD ACCESS SYSTEMS
    Product Code
    DQO
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT CAME TO INFUSION CENTER TO HAVE CATHETER REMOVED. IN ATTEMPT TO REMOVE THE CATHETER, IT SNAPPED LEAVING APPROX 3 TO 4 INCHES LONG IN THE VEIN. A TOURNIQUET WAS APPLIED TO PREVENT THE SEGMENT FROM FLOATING UP INTO THE PULMONARY VESSEL. DR WAS NOTIFIED. THE DR TOOK PT TO SDA, ATTEMPTED TO REMOVE PICC SEGMENT, WAS UNSUCCESSFUL. PT WAS TAKEN TO CATH LAB. ANOTHER DR WAS ABLE TO REMOVE THE BROKEN SEGMENT FROM THE PULMONARY VESSEL VIA THE FEMORAL ARTERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    23874 BARD-Q-CATH CATHETER DQO BARD ACCESS SYSTEMS #3 FRENCH PER-Q-CATH 22JK4421

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention