BEUDAMED
    FDA Adverse Event Other Summary report: N

    BAXTER FOGARTY

    MDR report key: 76543 · Received March 3, 1997

    Report

    Report Number
    76543
    Event Type
    Other
    Date Received
    March 3, 1997
    Date of Event
    January 13, 1997
    Report Date
    January 17, 1997
    Manufacturer
    BAXTER HEALTHCARE CORP. VASCULAR SYSTEMS DIV.
    Product Code
    DXE
    Report Source
    User Facility report
    Reporter Location
    MO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    CATHETER BROKE OFF IN DISTAL GRAFT ANOTHER "GRAFTING" WAS SUCCESSFUL IN RETRIEVING ABOUT 2 CM OF CATHETER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BAXTER FOGARTY ARTERIAL EMBOLECTOMY CATHETER DXE BAXTER HEALTHCARE CORP. VASCULAR SYSTEMS DIV. FOGARTY 120404F 6S07L 6S03L 6R11L

    Patients

    Seq Age Sex Outcome Treatment
    1 64 YR Other