BEUDAMED
    FDA Adverse Event Injury Summary report: N

    EGR SYSTEM (STERILE)

    MDR report key: 2841970 · Received November 14, 2012

    Report

    Report Number
    3004608878-2012-00212
    Event Type
    Injury
    Date Received
    November 14, 2012
    Report Date
    November 14, 2012
    Manufacturer
    INTEGRA LIFESCIENCES CORPORATION OH/USA
    Product Code
    NBH
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE INVOLVED IN THE REPORTED INCIDENT IS NOT AVAILABLE FOR EVAL. AN INVESTIGATION HAS BEEN INITIATED BASED ON THE REPORTED INFO.

    Description of Event or Problem · 1

    THE REPORTER NOTED: THE DOCTOR STATED THE PT HAD AN EGR PROCEDURE ON (B)(6) 2012. AT AN UNK DATE (NOT PROVIDED AFTER THE PROCEDURE, THE PT REPORTED "DISCOMFORT LATERALLY". THE DOCTOR BELIEVED THIS WAS NEURITIS AND PROVIDED THE PT'S CORTISONE INJECTION WHICH "RELIEVED THE PT'S DISCOMFORT."

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EGR SYSTEM (STERILE) ENDOSCOPIC GASTROC RELEASE NBH INTEGRA LIFESCIENCES CORPORATION OH/USA

    Patients

    Seq Age Sex Outcome Treatment
    1 50 YR Required Intervention