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