FDA Adverse Event Other Summary report: N

BARD ACCESS SYSTEMS

MDR report key: 583194 · Received March 4, 2005

Report

Report Number
583194
Event Type
Other
Date Received
March 4, 2005
Date of Event
February 15, 2005
Report Date
March 4, 2005
Manufacturer
BARD ACCESS SYSTEM
Product Code
DYB
Report Source
User Facility report
Reporter Location
TX, US

Narratives

Description of Event or Problem · 1

THE PATIENT WAS UNDER GOING A THROMBOLYSIS TO DECLOT A DIALYSIS THIGH GRAFT. USING A 4 FR COAXIAL MICROINTRODUCER KIT, THE GUIDWIRE (.018") WAS STUCK IN THE LEFT THIGH GRAFT AND BROKE OFF. THE PROCEDURE WAS ABORTED AND THE PATIENT WAS REFERRED TO A SURGEON FOR WIRE EXTRACTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BARD ACCESS SYSTEMS MICROINTRODUCER KIT DYB BARD ACCESS SYSTEM * 36JOMA02

Patients

Seq Age Sex Outcome Treatment
1 61 YR