BEUDAMED
    FDA Adverse Event Injury Summary report: N

    2031527-2012-00091

    MDR report key: 2699131 · Received August 15, 2012

    Report

    Report Number
    2031527-2012-00091
    Event Type
    Injury
    Date Received
    August 15, 2012
    Date of Event
    June 27, 2012
    Report Date
    June 27, 2012
    Manufacturer
    ENDOLOGIX, INC.
    PMA / PMN Number
    P040002
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    PHYSICIAN
    Health Professional
    Yes

    Patients

    Seq Age Sex Outcome Treatment
    1 70 YR Male Required Intervention