BEUDAMED
    FDA Adverse Event Injury Summary report: N

    FW100

    MDR report key: 16861998 · Received May 3, 2023

    Report

    Report Number
    3006258094-2023-00001
    Event Type
    Injury
    Date Received
    May 3, 2023
    Date of Event
    April 16, 2023
    Report Date
    April 17, 2023
    Manufacturer
    FISHER WALLACE LABORATORIES INC
    Product Code
    QJQ
    PMA / PMN Number
    TESTTEST
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 0

    TEST MDR SUBMISSION.

    Description of Event or Problem · 0

    TEST MDR SUBMISSION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    533812 FW100 FISHER WALLACE STIMULATOR QJQ FISHER WALLACE LABORATORIES INC FW100

    Patients

    Seq Age Sex Outcome Treatment
    1 32 YR Unknown Other