FDA Adverse Event Death Summary report: N

MAGNUM DISPOSABLE CORE BIOPSY INSTRUMENT

MDR report key: 4435793 · Received January 15, 2015

Report

Report Number
2020394-2015-00013
Event Type
Death
Date Received
January 15, 2015
Date of Event
November 25, 2014
Report Date
December 19, 2014
Manufacturer
BARD PERIPHERAL VASCULAR, INC.
Product Code
FCG
PMA / PMN Number
K934370
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PO
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE LOT NUMBER WAS NOT PROVIDED; THEREFORE, THE DEVICE HISTORY RECORDS COULD NOT BE REVIEWED. THE INVESTIGATION IS CURRENTLY UNDERWAY.

Description of Event or Problem · 1

IT WAS REPORTED THAT AT THE CONCLUSION OF A CT GUIDED BIOPSY PROCEDURE, THE PATIENT EXPERIENCED CARDIOPULMONARY ARREST. THE PATIENT EXPIRED DESPITE RESUSCITATIVE ATTEMPTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
36919 MAGNUM DISPOSABLE CORE BIOPSY INSTRUMENT FCG BARD PERIPHERAL VASCULAR, INC. UNK

Patients

Seq Age Sex Outcome Treatment
1 68 YR Death