BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HORIZON MEDICAL PRODUCTS, INC.

    MDR report key: 408192 · Received August 1, 2002

    Report

    Report Number
    408192
    Event Type
    Injury
    Date Received
    August 1, 2002
    Date of Event
    July 5, 2002
    Report Date
    July 8, 2002
    Manufacturer
    HORIZON MEDICAL PRODUCTS, INC.
    Product Code
    LJT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT CAME TO HOSPITAL BECAUSE VASCULAR PORT NOT WORKING. FLUOROSCOPY SHOWED CATHETER BROKEN AT THE LEVEL OF THE CLAVICLE. PIECE OF CATHETER IN RIGHT VENTRICLE. PORT AND SEGMENT REMOVED FROM PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HORIZON MEDICAL PRODUCTS, INC. TRIUMPH 1 VASCULAR ACCESS SYSTEM LJT HORIZON MEDICAL PRODUCTS, INC. * 1-523051A

    Patients

    Seq Age Sex Outcome Treatment
    1 48 YR Required Intervention