BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PERCUFLEX

    MDR report key: 282033 · Received June 16, 2000

    Report

    Report Number
    282033
    Event Type
    Injury
    Date Received
    June 16, 2000
    Date of Event
    May 23, 2000
    Report Date
    May 30, 2000
    Manufacturer
    MEDI-TECH, INC.
    Product Code
    FAD
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    PA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    RIGHT URETERAL STENT INSERTED IN 2000 FOR TREATMENT OF RENAL CALCULI. DISLODGED. RETURN TO SURGERY FOR REMOVAL/REPLACEMENT IN 2000. REPLACEMENT WITH 6X24 CM. STENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PERCUFLEX URETERAL STENT FAD MEDI-TECH, INC. 145-409 *

    Patients

    Seq Age Sex Outcome Treatment
    1 21 YR Required Intervention