BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    204 BROV 4.2 FR W/VITAC

    MDR report key: 348038 · Received August 15, 2001

    Report

    Report Number
    1720496-2001-00415
    Event Type
    Malfunction
    Date Received
    August 15, 2001
    Date of Event
    July 2, 2001
    Report Date
    July 19, 2001
    Manufacturer
    C.R. BARD, INC. (PUERTO RICO)
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    REMOVED CATHETER WITHOUT INCIDENT. THE CUFF WAS LEFT INSIDE THE PT & NOT REMOVED. NO PT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    37467 204 BROV 4.2 FR W/VITAC LONG TERM INTRAVASCULAR CATHETER DQO C.R. BARD, INC. (PUERTO RICO) 0600062 43ALI0019

    Patients

    Seq Age Sex Outcome Treatment
    1 Other