BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BARD ACCESS SYSTEMS

    MDR report key: 381846 · Received March 11, 2002

    Report

    Report Number
    MW1024333
    Event Type
    Malfunction
    Date Received
    March 11, 2002
    Date of Event
    November 19, 2001
    Report Date
    February 7, 2002
    Manufacturer
    C.R. BARD, INC.
    Product Code
    DQO
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NE, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    AFTER INSERTION OF GROSHONG CATHETER, UNABLE TO IRRIGATE OR ASPIRATE. CATHETER REMOVED BY PHYSICIAN AND NEW ONE INSERTED WITHOUT INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD ACCESS SYSTEMS GROSHONG 8 FR. SINGLE LUMEN CV CATHETER DQO C.R. BARD, INC. * 22KKA547

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR