BEUDAMED
    FDA Adverse Event Death Summary report: N

    PORT, CATHETER, IMPLANTED

    MDR report key: 6263447 · Received January 19, 2017

    Report

    Report Number
    6263447
    Event Type
    Death
    Date Received
    January 19, 2017
    Date of Event
    December 19, 2016
    Report Date
    January 5, 2017
    Manufacturer
    C.R. BARD INC.
    Product Code
    LJT
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    AZ, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PATIENT PRESENTED WITH A CRACKED HICKMAN CATHETER, WHICH WAS INITIALLY PLACED APPROXIMATELY FIFTEEN MONTHS AGO. AFTER CATHETER WAS REPLACED PATIENT NOTED TO BE DIAPHORETIC WITH LEFT SIDED NUMBNESS/WEAKNESS, AND A NOTICEABLE FACIAL DROOP. STROKE TEAM NOTIFIED. PATIENT SUFFERED A ACUTE STROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    47738 PORT, CATHETER, IMPLANTED LJT C.R. BARD INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Death NO