BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD ACCESS SYSTEMS, INC.

    MDR report key: 65565 · Received January 3, 1997

    Report

    Report Number
    65565
    Event Type
    Injury
    Date Received
    January 3, 1997
    Date of Event
    November 14, 1996
    Report Date
    November 19, 1996
    Manufacturer
    BARD ACCESS SYSTEMS, INC.
    Product Code
    LJT
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING THE SCHEDULED SURGICAL REMOVAL OF THE PT'S PAC, THE CATHETER SLIPPED AWAY AND INTO THE VENTRICLE. THE CATHETER WAS UNABLE TO BE RETRIEVED VIA SPECIAL PROCEDURES IN RADIOLOGY AND REQUIRED THE CARDIAC CATH TEAM TO RETRIEVE IT EVENTUALLY. NO INJURY OCCURRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BARD ACCESS SYSTEMS, INC. Implant PORT A CATH LJT BARD ACCESS SYSTEMS, INC. 0602850 35 KF 1357

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Hospitalization| R