BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD ACCESS SYSTEM

    MDR report key: 53579 · Received July 3, 1996

    Report

    Report Number
    53579
    Event Type
    Injury
    Date Received
    July 3, 1996
    Date of Event
    January 12, 1996
    Report Date
    July 1, 1996
    Manufacturer
    BARD MEDICAL SYSTEMS
    Product Code
    DQO
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    OH, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    CATHETER FRACTURE AT ENTRANCE TO THE SUPERIOR VENA CAVA VIA FLUOROSCOPY. DEVICE IMPLANTED 1/12/96, AT ANOTHER FACILITY. PT IS SCHEDULED TO FOLLOW UP FOR CATHETER FRACTURE WITH THE OTHER FACILITY ON 2/23/96.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD ACCESS SYSTEM VENOUS ACCESS SYSTEM DQO BARD MEDICAL SYSTEMS UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 *