BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RESTORE 3.4X10 TPS CYLIND

    MDR report key: 162786 · Received April 16, 1998

    Report

    Report Number
    2184002-1998-00265
    Event Type
    Injury
    Date Received
    April 16, 1998
    Date of Event
    November 5, 1997
    Report Date
    April 16, 1998
    Manufacturer
    LIFECORE BIOMEDICAL, INC.
    Product Code
    DZE
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IMPLANT PLACED 6/18/1997. PT CAME INTO CLINIC 11/5/97 WITH THE IMPLANT IN HIS HAND. ONE PERSON AFFECTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RESTORE 3.4X10 TPS CYLIND Implant ENDOSSEOUS IMPLANT DZE LIFECORE BIOMEDICAL, INC. R9040-34-10 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention