FDA Adverse Event
Injury
Summary report: N
3003496686-2011-16856
MDR report key: 2032574
·
Received March 24, 2011
Report
- Report Number
- 3003496686-2011-16856
- Event Type
- Injury
- Date Received
- March 24, 2011
- Report Date
- April 5, 2011
- PMA / PMN Number
- PO30050
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
- Health Professional
- N
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | NA | Female | Other| H |