PORT-A-CATH

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1995-03-01 for PORT-A-CATH manufactured by Davol/bard Access.

Event Text Entries

[14077] On december 22, 1994 a patient was taken to surgery for a removal of a port-a-cath. During the surgery only the dome port was retrieved. A chest x-ray indicated the port-a-cath tubing was in the left ventricle and into the pulmonary wein patient was taken to radiology where the remainder of the catheter was removed via fluoroscopic guidance. The records indicate that the port-a-cath was placed in august of 1994. Invalid data - regarding single use labeling of device. Patient medical status prior to event: invalid data. Invalid data - regarding multiple patient involvement. Invalid data - on device service/maintenance. No data - regarding date last serviced. Service provided by: invalid data. Invalid data - service records availability. Invalid data - regarding whether event presents imminent hazard. Invalid data - whether device used as labeled/intended. Invalid data - regarding evaluation by user after event. Method of evaluation: invalid data. Results of evaluation: invalid data. Conclusion: invalid data. Certainty of device as cause of or contributor to event: invalid data. Corrective actions: no data. Invalid data - on device destroyed/disposed of status.
Patient Sequence No: 1, Text Type: D, B5

MAUDE Entry Details

• Report Number: 20939
• MDR Report Key: 20939
• Date Received: 1995-03-01
• Date of Report: 1995-01-30
• Date of Event: 1994-12-22
• Report Date: 1995-01-30
• Date Added to Maude: 1995-03-24
• Event Key: 0
• Report Source Code: User Facility report
• Manufacturer Link: N
• Number of Patients in Event: 0
• Adverse Event Flag: 3
• Product Problem Flag: 3
• Reprocessed and Reused Flag: 0
• Health Professional: 0
• Initial Report to FDA: 0
• Report to FDA: 3
• Event Location: 3
• Single Use: 0
• Previous Use Code: 0
• Event Type: 3
• Type of Report: 3

Device Details

• Brand Name: PORT-A-CATH
• Product Code: LKG
• Date Received: 1995-03-01
• Device Availability: *
• Implant Flag: *
• Device Sequence No: 1
• Device Event Key: 20838
• Manufacturer: DAVOL/BARD ACCESS

Patients

Patient Number	Treatment	Outcome	Date
1	0	1. No Informationnvalid Deathata	1995-03-01