BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HUMMINGBIRD VENTRICULAR

    MDR report key: 5048851 · Received August 12, 2015

    Report

    Report Number
    5048851
    Event Type
    Injury
    Date Received
    August 12, 2015
    Date of Event
    August 1, 2015
    Report Date
    August 11, 2015
    Manufacturer
    INNERSPACE INC.
    Product Code
    HCA
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    HI, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    DURING PLACEMENT OF THE VENTRICULOSTOMY CATHETER THE FIRST CATHETER INSERTED UNFORTUNATELY WAS FRACTURED OR LACERATED BY THE INNER TABLE AND A FRAGMENT OF CATHETER WAS LEFT IN SITU.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    532302 HUMMINGBIRD VENTRICULAR VENTRICULAR CATHETER HCA INNERSPACE INC. H200MR 140616-03

    Patients

    Seq Age Sex Outcome Treatment
    1 24 YR Hospitalization