BEUDAMED
    FDA Adverse Event Injury Summary report: N

    SGW STABLIZR .014 180CM J SS

    MDR report key: 310574 · Received January 3, 2001

    Report

    Report Number
    1016427-2001-00002
    Event Type
    Injury
    Date Received
    January 3, 2001
    Date of Event
    November 1, 2000
    Report Date
    January 3, 2001
    Manufacturer
    CORDIS CORP. (MIAMI)
    Product Code
    DQX
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE FLOPPY PART OF THE WIRE BROKE IN THE OBTUSE MARGINAL BRANCH OF THE CORONARY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    341 SGW STABLIZR .014 180CM J SS CARDIOLOGY WIRES AND METALS DQX CORDIS CORP. (MIAMI) NA 40300188

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN