BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MEDI. TECH BOSTON SCIENTIFIC CORP.

    MDR report key: 223902 · Received May 6, 1999

    Report

    Report Number
    223902
    Event Type
    Injury
    Date Received
    May 6, 1999
    Date of Event
    January 28, 1999
    Report Date
    March 3, 1999
    Manufacturer
    MEDI TECH BOSTON SCIENTIFIC CORP.
    Product Code
    DTK
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    VENA CAVA UMBRELLA DID NOT DEPLOY - SURGEON WAS ABLE TO REINSERT AND DEPLOY ANOTHER DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDI. TECH BOSTON SCIENTIFIC CORP. Implant * DTK MEDI TECH BOSTON SCIENTIFIC CORP. * 2108164

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Required Intervention