BEUDAMED
    FDA Adverse Event Injury Summary report: N

    WOUND EVAC EASY TOUCH

    MDR report key: 34726 · Received June 28, 1996

    Report

    Report Number
    34726
    Event Type
    Injury
    Date Received
    June 28, 1996
    Date of Event
    June 15, 1996
    Report Date
    June 24, 1996
    Manufacturer
    MICRO TEK MEDICAL, INC.
    Product Code
    GCY
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    SUPERFICIALLY PLACED DRAIN IN LUMBAR AREA BROKE UPON REMOVAL ATTEMPT. PT RETURNED TO SURGERY AND RETAINED DRAIN TUBING REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WOUND EVAC EASY TOUCH Implant HEMOVAC GCY MICRO TEK MEDICAL, INC. 400-ET-02 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Hospitalization| O