FDA Adverse Event
Malfunction
Summary report: N
1810909-1999-00003
MDR report key: 221378
·
Received April 21, 1999
Report
- Report Number
- 1810909-1999-00003
- Event Type
- Malfunction
- Date Received
- April 21, 1999
- Date of Event
- February 26, 1999
- Product Code
- FMK
- Report Source
- Manufacturer report
Narratives
Description of Event or Problem · 1
INFO WAS RECEIVED ON AN OBSOLETE MEDWATCH FORM FDA FORM 3500 (6/93).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | FMK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |