BEUDAMED
    FDA Adverse Event Injury Summary report: N

    STEFFE PEDICLE SCREW

    MDR report key: 22409 · Received June 13, 1995

    Report

    Report Number
    MW1006212
    Event Type
    Injury
    Date Received
    June 13, 1995
    Date of Event
    December 1, 1990
    Manufacturer
    MICRO MED, INC.
    Product Code
    MCV
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    THIS LETTER IS TO INFORM YOU THAT THIS MED WATCH FORM WAS RETURNED TO MICRO-MED, INC. IN ERROR. MICRO-MED, IS NOT A MFR OF PEDICLE SCREWS; AS DESCRIBED IN THIS REPORT. I CANNOT OFFER AN EXPLANATION AS TO HOW MICRO-MED'S NAME APPEARED ON THIS FORM, BUT I CAN ASSURE YOU THAT WE DO NOT MFG THIS ITEM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STEFFE PEDICLE SCREW Implant PEDICLE SCREW MCV MICRO MED, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR Disability