BEUDAMED
    FDA Adverse Event Injury Summary report: N

    JJJ

    MDR report key: 19575006 · Received June 20, 2024

    Report

    Report Number
    3008382007-2024-03001
    Event Type
    Injury
    Date Received
    June 20, 2024
    Date of Event
    June 20, 2024
    Report Date
    June 20, 2024
    Manufacturer
    QIPLA
    Product Code
    DXZ
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1603893 JJJ PATCH, PLEDGET AND INTRACARDIAC, PETP, PTFE, POLYPROPYLENE DXZ QIPLA KKK 001

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR Female Hospitalization