BEUDAMED
    FDA Adverse Event Injury Summary report: N

    GROSHONG

    MDR report key: 359681 · Received October 30, 2001

    Report

    Report Number
    1720496-2001-00478
    Event Type
    Injury
    Date Received
    October 30, 2001
    Report Date
    September 10, 2001
    Manufacturer
    BARD ACCESS SYSTEMS
    Product Code
    DQO
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    EXTERNAL BREAK AND EMBOLIZATION ON D/L PICC. REMOVED WITHOUT PT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    48614 GROSHONG LONG TERM INTRAVASCULAR CATHETER DQO BARD ACCESS SYSTEMS UNK NI

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention