BEUDAMED
    FDA Adverse Event Death Summary report: N

    BARD

    MDR report key: 444276 · Received February 18, 2003

    Report

    Report Number
    444276
    Event Type
    Death
    Date Received
    February 18, 2003
    Date of Event
    November 29, 2002
    Report Date
    February 17, 2003
    Manufacturer
    C.R. BARD, INC.
    Product Code
    MSD
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    NM, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DEVICE INSERTED 2002 WITHOUT APPARENT COMPLICATION. NO NOTED PROBLEMS WITH DEVICE WHILE INPATIENT, PT DISCHARGED HOME 4 DAYS LATER. DEVICE SOMEHOW "DISPLACED" OR "DISLODGED" AT HOME AND PT EXSANGUINATED.

    Description of Event or Problem · 1

    ADD'L INFO RECEIVED FROM MFR 3/20/03: UNFORTUNATELY, THE RESULTS OF THE EVALUATION WILL BE INCONCLUSIVE, AS THE DEVICE IS NOT AVAILABLE FOR EVALUATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD CENTRAL VENOUS CATHETER (DIALYSIS) MSD C.R. BARD, INC. * 22HM9187

    Patients

    Seq Age Sex Outcome Treatment
    1 81 YR Death