BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NEFF INFRARENAL AORTOILIAC CATHETER

    MDR report key: 36908 · Received September 9, 1996

    Report

    Report Number
    1820334-1996-00003
    Event Type
    Injury
    Date Received
    September 9, 1996
    Report Date
    August 13, 1996
    Manufacturer
    COOK INCORPORATED
    Product Code
    LFK
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    BE
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    DEVICE WAS INTRODUCED AND AN INJECTION PERFORMED. UPON ATTEMPTED REMOVAL, THE CATHETER TIP SEPARATED. A RETRIEVAL DEVICE WAS UTILIZED FOR REMOVAL OF THE SEPARATED SEGMENT. PT HAS NOT SUSTAINED ANY ADVERSE EFFECT FROM THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 NEFF INFRARENAL AORTOILIAC CATHETER CATHETER LFK COOK INCORPORATED NA F81911

    Patients

    Seq Age Sex Outcome Treatment
    1 65 YR Required Intervention