BEUDAMED
    FDA Adverse Event Death Summary report: N

    PHILIPS

    MDR report key: 310389 · Received December 29, 2000

    Report

    Report Number
    MW1020702
    Event Type
    Death
    Date Received
    December 29, 2000
    Date of Event
    March 13, 1998
    Report Date
    December 28, 2000
    Manufacturer
    PHILIPS MEDICAL SYSTEM NORTH AMERICA CO
    Product Code
    KXJ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    SC, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PHILIPS CATHERIZATION TABLE ADU 2 KXJ PHILIPS MEDICAL SYSTEM NORTH AMERICA CO 9804 401 91101 *
    2 PHILIPS CATHERIZATION TABLE TOP KXJ PHILIPS MEDICAL SYSTEM NORTH AMERICA CO 9804-643-00101 *

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Death