FDA Adverse Event
Injury
Summary report: N
BOSTON SCIENTIFIC CORPORATION A00343
MDR report key: 6686536
·
Received July 3, 2017
Report
- Report Number
- 6686536
- Event Type
- Injury
- Date Received
- July 3, 2017
- Date of Event
- June 29, 2017
- Report Date
- June 29, 2017
- Product Code
- GBO
- Product Problem
- Yes
- Report Source
- User Facility report
- Reporter Location
- TX, US
- Reporter Occupation
- NURSE
Narratives
Description of Event or Problem · 1
WHILE PHYSICIAN WAS ATTEMPTING TO REMOVE THE MALECOT NEPHROSTOMY TUBE 16F, IT TORE REQUIRING A RETURN TO SURGERY TO RETRIEVE THE OTHER PORTION OF THE TUBE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 464369 | BOSTON SCIENTIFIC CORPORATION A00343 | RE-ENTRY MALECOT NEPHROSTOMY CATHETER SET | GBO | M0064101050 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 62 YR | Required Intervention |