BEUDAMED
    FDA Adverse Event Injury Summary report: N

    STARTER KIT, SIZE 3, 1213

    MDR report key: 100770 · Received June 23, 1997

    Report

    Report Number
    1224675-1997-00040
    Event Type
    Injury
    Date Received
    June 23, 1997
    Date of Event
    April 29, 1997
    Report Date
    June 17, 1997
    Manufacturer
    UROMED CORP.
    Product Code
    MNG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NV, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    PATIENT REPORTED A KIDNEY INFECTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STARTER KIT, SIZE 3, 1213 RELIANCE MNG UROMED CORP. SIZE 3 0000000008

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention