BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    THREADED END (UTS) ADAPTER

    MDR report key: 3146928 · Received May 31, 2013

    Report

    Report Number
    1213649-2013-00021
    Event Type
    Malfunction
    Date Received
    May 31, 2013
    Date of Event
    April 23, 2013
    Report Date
    May 28, 2013
    Manufacturer
    CADENCE INC
    Product Code
    DTL
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    ON (B)(6) 2013, IT WAS REPORTED THE ADAPTER DID NOT HAVE A THROUGH-HOLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    241194 THREADED END (UTS) ADAPTER ADAPTER DTL CADENCE INC 6529 W005287/1

    Patients

    Seq Age Sex Outcome Treatment
    1 Other