BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BARD

    MDR report key: 3811824 · Received May 8, 2014

    Report

    Report Number
    MW5036078
    Event Type
    Malfunction
    Date Received
    May 8, 2014
    Date of Event
    April 29, 2014
    Report Date
    May 8, 2014
    Manufacturer
    BARD
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    IL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    BLOOD LEAKED OUT THROUGH THE PORT NEEDLE AND TUBING. NO HARM TO PATIENT. (B)(6).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    279647 BARD POWER PORT 20G 3/4 INCH LJT BARD ASYCS002

    Patients

    Seq Age Sex Outcome Treatment
    1 7 YR Other