BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DELTAPAQ - CERECYTE MICROCOIL

    MDR report key: 2950013 · Received February 8, 2013

    Report

    Report Number
    2954740-2012-00719
    Event Type
    Injury
    Date Received
    February 8, 2013
    Date of Event
    March 9, 2012
    Manufacturer
    MICRUS ENDOVASCULAR, LLC
    Product Code
    HCG
    PMA / PMN Number
    K080437
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    55404 DELTAPAQ - CERECYTE MICROCOIL NEUROVASCULAR EMBOLIZATION DEVICE HCG MICRUS ENDOVASCULAR, LLC

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Female Other