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Adverse Event Report

BARD BARD PORT IMPLANTED PORT   back to search results
Event Date 07/01/1997
Patient Outcome  Hospitalization;
Event Description

Inserted infusaport broke off inside of pt & ended up in the right ventricle.

 
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Brand NameBARD PORT
Type of DeviceIMPLANTED PORT
Baseline Device 510(K) Number
Baseline Device PMA Number
Manufacturer (Section F)
BARD
*
Manufacturer (Section D)
BARD
*
Device Event Key104862
MDR Report Key106679
Event Key100276
Report Number106679
Device Sequence Number1
Product CodeLJT
Report Source User Facility
Reporter Occupation Invalid Data
Type of Report Initial
Report Date 07/02/1997
1 Device Was Involved in the Event
1 Patient Was Involved in the Event
Date FDA Received07/18/1997
Is This An Adverse Event Report? No
Is This A Product Problem Report? Yes
Device Operator Health Professional
Was Device Available For Evaluation? Yes
Is The Reporter A Health Professional? No Answer Provided
Was the Report Sent to FDA? No
Event Location Home
Is the Device an Implant? No
Is this an Explanted Device? No Answer Provided

Database last updated on February 28, 2009

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