BEUDAMED
    FDA Adverse Event Death Summary report: N

    MALLINCKRODT

    MDR report key: 74826 · Received March 4, 1997

    Report

    Report Number
    74826
    Event Type
    Death
    Date Received
    March 4, 1997
    Date of Event
    February 27, 1997
    Report Date
    March 3, 1997
    Manufacturer
    MALLINCKRODT MED., INC.
    Product Code
    KTA
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    LA, US
    Reporter Occupation
    RADIOLOGIC TECHNOLOGIST

    Narratives

    Description of Event or Problem · 1

    ANAPHYLACTIC SHOCK REACTION AFTER RECEIVING IVP CONTRAST. PT EXPIRED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MALLINCKRODT CONRAY 43 KTA MALLINCKRODT MED., INC. * T155E, EXPIRE 7/99

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Death