BEUDAMED
    FDA Adverse Event Injury Summary report: N

    IMPACTOR / LXH

    MDR report key: 1354293 · Received April 1, 2009

    Report

    Report Number
    1020279-2009-00537
    Event Type
    Injury
    Date Received
    April 1, 2009
    Date of Event
    March 12, 2009
    Report Date
    March 31, 2009
    Manufacturer
    BROOKS MANUFACTURING SITE
    Product Code
    LXH
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    NA

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE IMPACTOR BROKE OFF DURING THE SURGERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 IMPACTOR / LXH LXH BROOKS MANUFACTURING SITE UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 53 YR Other