BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ALLO SOURCE/UROMED CORP.

    MDR report key: 215107 · Received March 17, 1999

    Report

    Report Number
    215107
    Event Type
    Malfunction
    Date Received
    March 17, 1999
    Date of Event
    March 12, 1999
    Report Date
    March 15, 1999
    Manufacturer
    ALLO SOURCE/UROMED CORP.
    Product Code
    MNG
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    ALLO SOURCE; ALLO SLING FASCIA; PRODUCT CODE 120270. FASCIA LATA W2 X L15 CM; FASCIA LATA NOT SIZE STATED (TOO SMALL).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ALLO SOURCE/UROMED CORP. FASCIA LATA MNG ALLO SOURCE/UROMED CORP. 120270 *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other