BEUDAMED
    FDA Adverse Event Death Summary report: N

    BARD

    MDR report key: 511801 · Received February 17, 2004

    Report

    Report Number
    511801
    Event Type
    Death
    Date Received
    February 17, 2004
    Date of Event
    February 7, 2004
    Report Date
    February 12, 2004
    Manufacturer
    C.R. BARD INC.
    Product Code
    DKT
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    INFERIOR VENA CAVA FILTER MIGRATED INTO THE RIGHT ATRIUM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD FEMORAL RECOVERY FILTER, FEMORAL SYSTEM DKT C.R. BARD INC. RF-048F 07GN3276

    Patients

    Seq Age Sex Outcome Treatment
    1 34 YR Death