BEUDAMED
    FDA Adverse Event Injury Summary report: N

    AVECOR CARDIOVASCULAR INC.

    MDR report key: 249824 · Received November 12, 1999

    Report

    Report Number
    MW1017552
    Event Type
    Injury
    Date Received
    November 12, 1999
    Date of Event
    October 12, 1999
    Report Date
    November 11, 1999
    Manufacturer
    MEDTRONIC, INC.
    Product Code
    DWF
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    ADDITIONAL INFO RECEIVED FROM MFR ON 1/14/2000: A MEDWATCH REPORT WAS FILED DECEMBER 10, 1999; MFR REPORT NUMBER 2184009-1999-00018.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AVECOR CARDIOVASCULAR INC. TYGON DWF MEDTRONIC, INC. * CP96D18C

    Patients

    Seq Age Sex Outcome Treatment
    1 22 MO Required Intervention