MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1996-11-14 for BARDPORT IMPLANTED PORT 0602270 * manufactured by Bard Access Systems.
[16264655]
During routine cxr it was noted that catheter tip had separated from catheter. Catheter tip removed by radiology with no complications.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 50241 |
| MDR Report Key | 50241 |
| Date Received | 1996-11-14 |
| Date of Report | 1996-11-13 |
| Date of Event | 1996-07-22 |
| Date Facility Aware | 1996-11-05 |
| Report Date | 1996-11-13 |
| Date Added to Maude | 1996-11-21 |
| 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 |
| Reporter Occupation | RISK MANAGER |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | BARDPORT IMPLANTED PORT |
| Generic Name | VASCULAR ACCESS PORT |
| Product Code | LJY |
| Date Received | 1996-11-14 |
| Model Number | 0602270 |
| Catalog Number | * |
| Lot Number | 36JF1002 |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | * |
| Implant Flag | Y |
| Date Removed | V |
| Device Sequence No | 1 |
| Device Event Key | 50951 |
| Manufacturer | BARD ACCESS SYSTEMS |
| Manufacturer Address | 5425 W AMELIA EARHART DR SALT LAKE CITY UT 84116 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 1996-11-14 |