BEUDAMED
    FDA Adverse Event Injury Summary report: N

    C.R. BARD, INC.

    MDR report key: 571110 · Received February 4, 2005

    Report

    Report Number
    571110
    Event Type
    Injury
    Date Received
    February 4, 2005
    Date of Event
    December 10, 2004
    Report Date
    December 22, 2004
    Manufacturer
    C.R. BARD, INC.
    Product Code
    GCY
    Report Source
    User Facility report
    Reporter Location
    OH, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    CHANNEL SILICONE DRAIN PLACED POST OPERATIVLY IN 2004. DURING REMOVAL OF DRAIN TWO DAYS LATER DRAIN BROKE OFF AND WAS RETAINED IN THE PT'S PELVIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 C.R. BARD, INC. CHANNEL SILICONE DRAIN GCY C.R. BARD, INC. UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Required Intervention