BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD ACCESS SYSTEMS

    MDR report key: 518127 · Received March 24, 2004

    Report

    Report Number
    518127
    Event Type
    Injury
    Date Received
    March 24, 2004
    Date of Event
    February 16, 2004
    Report Date
    March 18, 2004
    Manufacturer
    C.R. BARD
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    WV, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    PT WAS TAKEN TO RADIOLOGY SPECIAL PREOCEDURES SUITE FOR REMOVAL OF A FRACTURED MEDIPORT CATHETER WITH THE DISTAL END EMOLIZED TO THE HEART. ACCESS WAS OBTAINED IN THE RIGHT COMMON FEMORAL VEIN WITH ULTRASOUND GUIDANCE. A 25MM LOOPED SNARE WAS USED & SUCCESSFULLY ENGAGED TO THE FRACTURED CATHETER PIECE TO REMOVE IT FROM THE RIGHT ATRIUM & VENTRICLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD ACCESS SYSTEMS BARD PORT WITH GROSHONG CATHETER LJT C.R. BARD 0602850 22AM8056

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Required Intervention