BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LIFEPORT VASCULAR ACCESS SYSTEM

    MDR report key: 379108 · Received February 26, 2002

    Report

    Report Number
    1056436-2002-00027
    Event Type
    Malfunction
    Date Received
    February 26, 2002
    Date of Event
    January 23, 2002
    Report Date
    February 26, 2002
    Manufacturer
    HORIZON MEDICAL PRODUCTS, INC.
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ON 02/2002, THE USER FACILITIES OR BUYER INFORMED THE MFR'S SALES REP OF THE FOLLOWING: PLASTIC CONNECTOR WOULD NOT CONNECT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIFEPORT VASCULAR ACCESS SYSTEM VASCULAR ACCESSPORT LJT HORIZON MEDICAL PRODUCTS, INC. NA 15859

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Other