BEUDAMED
    FDA Adverse Event Injury Summary report: N

    UNK

    MDR report key: 3890141 · Received May 27, 2014

    Report

    Report Number
    3890141
    Event Type
    Injury
    Date Received
    May 27, 2014
    Date of Event
    May 9, 2014
    Report Date
    May 27, 2014
    Manufacturer
    UNK
    Product Code
    DQY
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US

    Narratives

    Description of Event or Problem · 1

    SEVERAL ATTEMPTS WERE MADE AT REMOVING A DIRECT RIGHT ATRIUM LINE FROM THE PATIENT. UNABLE TO REMOVE THE LINE EASILY AND THE DOCTOR WAS CALLED TO BEDSIDE. HE ATTEMPTED TO REMOVE THE DIRECT RIGHT ATRIUM LINE AND THE CATHETER BROKE LEAVING APPROXIMATELY 5 CM INSIDE THE PATIENT'S HEART. STAT CHEST X-RAYS WERE ORDERED AND EVALUATED BY THE DOCTOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    311795 UNK CATHETER DQY UNK * *

    Patients

    Seq Age Sex Outcome Treatment
    1 0 * Hospitalization| R