BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWER PORT PORTACATH

    MDR report key: 8382044 · Received February 28, 2019

    Report

    Report Number
    MW5084547
    Event Type
    Malfunction
    Date Received
    February 28, 2019
    Date of Event
    February 26, 2019
    Report Date
    February 26, 2019
    Manufacturer
    BARD ACCESS SYSTEMS
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    BARD ACCESS SYSTEMS, POWER PORT, PORTACATH, WOULD NOT ALLOW A BLOOD RETURN UPON IMPLANTATION. THIS DEVICE WAS REMOVED AND REPLACED WITH A ¿LIKE¿ DEVICE THAT THEN FUNCTIONED WITHOUT ISSUE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    170296 POWER PORT PORTACATH PORT CATHETER IMPLANTED SUBCUTANEOUS INTRAVASCULAR LJT BARD ACCESS SYSTEMS 1808000 RECX1821

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR