BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PILLING

    MDR report key: 218817 · Received April 12, 1999

    Report

    Report Number
    218817
    Event Type
    Injury
    Date Received
    April 12, 1999
    Date of Event
    March 24, 1999
    Report Date
    April 8, 1999
    Manufacturer
    PILLING CO
    Product Code
    DWP
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    FL, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING A SURGICAL CASE, A PILLING #1.5 CORONARY DILATOR BROKE OFF IN THE CORONARY ARTERY. IT WAS RETRIEVED BY THE SURGEON IMMEDIATELY AND SUCCESSFULLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PILLING CORONARY DILATOR DWP PILLING CO CC7 (1997) *

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Required Intervention