BEUDAMED
    FDA Adverse Event Injury Summary report: N

    BREG PAIN PUMP

    MDR report key: 1701022 · Received May 24, 2010

    Report

    Report Number
    2028253-2010-00011
    Event Type
    Injury
    Date Received
    May 24, 2010
    Date of Event
    April 18, 2002
    Report Date
    May 21, 2010
    Manufacturer
    BREG, INC.
    Product Code
    MEB
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    PT HAD R SHOULDER SURGERY ON (B) (6) 2002. CLAIM INDICATES THAT BREG PAIN PUMP WAS USED, MODEL NUMBER NOT IDENTIFIED AT THIS TIME. PT ALLEGES GLENOHUMERAL CHONDROLYSIS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BREG PAIN PUMP NONE MEB BREG, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 29 YR Disability