BEUDAMED
    FDA Adverse Event Other Summary report: N

    PE ADULT-PED WEST MULTI-LANG

    MDR report key: 185954 · Received September 4, 1998

    Report

    Report Number
    1221601-1998-00005
    Event Type
    Other
    Date Received
    September 4, 1998
    Date of Event
    August 4, 1998
    Report Date
    September 3, 1998
    Manufacturer
    GENZYME SURGICAL PRODUCTS CORP.
    Product Code
    KDQ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CONNECTOR COMPONENT BROKE DURING USE. NO PT COMPLICATIONS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PE ADULT-PED WEST MULTI-LANG PLEUR-EVAC WET SYSTEM KDQ GENZYME SURGICAL PRODUCTS CORP. A-8000-08 *

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other