BEUDAMED
    FDA Adverse Event Other Summary report: N

    *

    MDR report key: 379240 · Received March 1, 2002

    Report

    Report Number
    1032347-2002-00002
    Event Type
    Other
    Date Received
    March 1, 2002
    Date of Event
    January 1, 2001
    Report Date
    March 1, 2002
    Manufacturer
    WALTER LORENZ SURGICAL, INC.
    Product Code
    MQN
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    AFTER A RESECTION IN THE MANDIBLE, THE PLATE WAS PLACED WITHOUT THE USE OF A GRAFT. THE PLATE BROKE AFTER SEVERAL MONTHS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * TITANIUM PLATE MQN WALTER LORENZ SURGICAL, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other