BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    LIGATURE ANCHOR

    MDR report key: 21710 · Received May 9, 1995

    Report

    Report Number
    MW1005854
    Event Type
    Malfunction
    Date Received
    May 9, 1995
    Date of Event
    April 11, 1995
    Report Date
    April 17, 1995
    Manufacturer
    MITEK SURGICAL PRODUCTS, INC.
    Product Code
    KGS
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    WV, US
    Reporter Occupation
    NURSE

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIGATURE ANCHOR LIGATURE ANCHOR KGS MITEK SURGICAL PRODUCTS, INC. 940758

    Patients

    Seq Age Sex Outcome Treatment
    1 17 YR Other