BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARDPORT IMPLANTED PORT

    MDR report key: 50241 · Received November 14, 1996

    Report

    Report Number
    50241
    Event Type
    Injury
    Date Received
    November 14, 1996
    Date of Event
    July 22, 1996
    Report Date
    November 13, 1996
    Manufacturer
    BARD ACCESS SYSTEMS
    Product Code
    LJY
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MI, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING ROUTINE CXR IT WAS NOTED THAT CATHETER TIP HAD SEPARATED FROM CATHETER. CATHETER TIP REMOVED BY RADIOLOGY WITH NO COMPLICATIONS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARDPORT IMPLANTED PORT Implant VASCULAR ACCESS PORT LJY BARD ACCESS SYSTEMS 0602270 36JF1002

    Patients

    Seq Age Sex Outcome Treatment
    1 45 YR Required Intervention