BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BARD

    MDR report key: 6297725 · Received January 31, 2017

    Report

    Report Number
    MW5067615
    Event Type
    Malfunction
    Date Received
    January 31, 2017
    Date of Event
    January 9, 2017
    Report Date
    January 16, 2017
    Manufacturer
    BARD MEDICAL
    Product Code
    GCY
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    KY, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    ATTEMPT MADE TO REMOVE JP DRAIN FROM LLQ. DRAIN TUBING SEVERED AND REMAINDER OF TUBING RECOILED INTO THE ABDOMEN. PATIENT RETURNED TO SURGERY FOR REMOVAL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    73332 BARD BLAKE JP DRAIN GCY BARD MEDICAL

    Patients

    Seq Age Sex Outcome Treatment
    1 40 YR