BEUDAMED
    FDA Adverse Event Other Summary report: N

    DRAIN JACKSON PRATT RND

    MDR report key: 653110 · Received December 15, 2005

    Report

    Report Number
    1423507-2005-00148
    Event Type
    Other
    Date Received
    December 15, 2005
    Date of Event
    November 16, 2005
    Report Date
    December 15, 2005
    Manufacturer
    CARDINAL HEALTH
    Product Code
    GBX
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHEN DRAIN WAS PULLED OUT FROM THE PT'S BODY, IT BROKE. REMAINDER OF WOUND DRAIN HAD TO BE REMOVED SURGICALLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DRAIN JACKSON PRATT RND WOUND DRAIN GBX CARDINAL HEALTH SU130-1330 1991440

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention