BEUDAMED
    FDA Adverse Event Injury Summary report: N

    JACKSON PRATT DRAIN

    MDR report key: 764351 · Received August 28, 2006

    Report

    Report Number
    764351
    Event Type
    Injury
    Date Received
    August 28, 2006
    Date of Event
    July 20, 2006
    Report Date
    July 24, 2006
    Manufacturer
    BARD MEDICAL
    Product Code
    GCY
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PT S/P RADICAL PROSTATECTOMY WITH 2 JP DRAINS. DURING REMOVAL OF DRAINS ONE DRAIN BROKE OFF & REMAINED IN ABDOMEN. REQUIRED RETURN TO OR FOR REMOVAL OF DRAIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JACKSON PRATT DRAIN DRAIN GCY BARD MEDICAL * *

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Required Intervention