BEUDAMED
    FDA Adverse Event Injury Summary report: N

    *

    MDR report key: 47389 · Received October 23, 1996

    Report

    Report Number
    47389
    Event Type
    Injury
    Date Received
    October 23, 1996
    Report Date
    October 21, 1996
    Manufacturer
    COOK PACEMAKER CORP.
    Product Code
    LJT
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    ACCORDING TO THE PT, AFTER INFUSION DIFFICULTY ABOUT 12 MONTHS POST IMPLANT, CATHETER FRACTURE WITH EMBOLIZATION OF THE DISTAL SEGMENT TO THE PULMONARY ARTERY WAS DIAGNOSED AND THE SEGMENT SUCCESSFULLY RETRIEVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * CPC VITAL-PORT LJT COOK PACEMAKER CORP. UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 30 YR Hospitalization| R NOT AVAILABLE