BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ANGIODYNAMICS

    MDR report key: 370618 · Received January 4, 2002

    Report

    Report Number
    MW1023768
    Event Type
    Injury
    Date Received
    January 4, 2002
    Date of Event
    November 28, 2001
    Report Date
    January 4, 2002
    Manufacturer
    ANGIODYNAMICS
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    WHILE REMOVING CATHETER APPROX 8-10 CM OF THE TIP OF THE CATHETER SEPARATED AND REMAINED IN THE RIGHT ILIAC ARTERY. REMOVING PIECE OF FRACTURED CATHETER HAD TO BE REMOVED WITH SNARE. PT SUFFERED NO INJURIES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANGIODYNAMICS CATHETER DQO ANGIODYNAMICS SIMMONS - SIDEWINDER -2- 522266

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Required Intervention