BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BARD

    MDR report key: 6989941 · Received October 31, 2017

    Report

    Report Number
    MW5073044
    Event Type
    Injury
    Date Received
    October 31, 2017
    Date of Event
    October 23, 2017
    Report Date
    October 27, 2017
    Manufacturer
    BARD MEDICAL DIVISION
    Product Code
    FPA
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 1

    UNABLE TO ACCESS PT WITH POWER PORT NEEDLE. UPON PUNCTURING SKIN, NOTED NEEDLE TO BEND. UNABLE TO LOWER NEEDLE INTO POSITION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    771207 BARD POWER LOC SAFETY INFUSION SET FPA BARD MEDICAL DIVISION 0672234 ASBRS0128

    Patients

    Seq Age Sex Outcome Treatment
    1 16 YR Required Intervention