BEUDAMED
    FDA Adverse Event Other Summary report: N

    *

    MDR report key: 309819 · Received December 20, 2000

    Report

    Report Number
    309819
    Event Type
    Other
    Date Received
    December 20, 2000
    Date of Event
    December 6, 2000
    Report Date
    December 19, 2000
    Manufacturer
    WALTER LORENZ SURGICAL INC.
    Product Code
    DZL
    Report Source
    User Facility report
    Reporter Location
    AL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    BONE PLATES DISCOVERED BROKEN IN RIGHT MAXILLA. SCREWS AND PLATES REMOVED AND REPLACED WITH NEW SCREWS AND PLATES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * BONE SCREWS & PLATES DZL WALTER LORENZ SURGICAL INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR Other