BEUDAMED
    FDA Adverse Event Death Summary report: N

    BD POWERPICC SOLO 2 5FR TRIPLE LUMEN (WIRE)

    MDR report key: 9763520 · Received February 26, 2020

    Report

    Report Number
    MW5093307
    Event Type
    Death
    Date Received
    February 26, 2020
    Date of Event
    February 14, 2020
    Report Date
    February 24, 2020
    Manufacturer
    BARD ACCESS SYSTEMS, INC.
    Product Code
    LJS
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    RETAINED WIRE DISCOVERED ON POST-PROCEDURE X-RAY INSIDE PT'S RIGHT VENTRICLE. FDA SAFETY REPORT ID# (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    222628 BD POWERPICC SOLO 2 5FR TRIPLE LUMEN (WIRE) CATHETER, INTRAVASCULAR, THERAPEUTIC LONG-TERM GREATER THAN 30 DAYS LJS BARD ACCESS SYSTEMS, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 360 YR Death| S