BEUDAMED
    FDA Adverse Event Injury Summary report: N

    *

    MDR report key: 97710 · Received July 1, 1996

    Report

    Report Number
    97710
    Event Type
    Injury
    Date Received
    July 1, 1996
    Date of Event
    January 2, 1996
    Report Date
    July 1, 1996
    Manufacturer
    PHARMACIA DELTEC, INC.
    Product Code
    LJT
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    ON 8/4/93, THE PT HAD A CATHETER REPLACED. ON 12/29/95, THE PT HAD A CHEST X-RAY TAKEN WHICH SHOWED THE TIP OF THE CATHETER IN THE RIGHT ATRIUM. ON 1/2/96, THE PT HAD THE BROKEN TIP REMOVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * Implant PORT-A-CATH LJT PHARMACIA DELTEC, INC. 214000 20207

    Patients

    Seq Age Sex Outcome Treatment
    1 33 YR Required Intervention