BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BROVIAC

    MDR report key: 3779169 · Received April 16, 2014

    Report

    Report Number
    3779169
    Event Type
    Malfunction
    Date Received
    April 16, 2014
    Date of Event
    April 8, 2014
    Report Date
    April 16, 2014
    Manufacturer
    BARD ACCESS SYSTEMS, INC
    Product Code
    LJS
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    CT, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    SURGICAL TECH REPORTED RESISTANCE AND THAT THE GLIDEWIRE DID NOT SLIDE SMOOTHLY WHILE PREPARING FOR HANDOFF TO THE SURGEON.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    233915 BROVIAC CATHETER LJS BARD ACCESS SYSTEMS, INC * HUWL0279

    Patients

    Seq Age Sex Outcome Treatment
    1 3 YR