BEUDAMED
    FDA Adverse Event Other Summary report: N

    PRISMA SET

    MDR report key: 1080691 · Received July 21, 2008

    Report

    Report Number
    2087532-2008-00063
    Event Type
    Other
    Date Received
    July 21, 2008
    Date of Event
    June 12, 2008
    Report Date
    June 12, 2008
    Manufacturer
    GAMBRO INDUSTRIES
    Product Code
    FJK
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    KS, US
    Reporter Occupation
    NURSE

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRISMA SET PRISMA M100 PRE SET FJK GAMBRO INDUSTRIES M100 PRE SET 06J1675G

    Patients

    Seq Age Sex Outcome Treatment
    1 92 YR Other