BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    JAMIE EYEQ

    MDR report key: 388048 · Received April 7, 2002

    Report

    Report Number
    MW1024684
    Event Type
    Malfunction
    Date Received
    April 7, 2002
    Report Date
    April 7, 2002
    Manufacturer
    *
    Product Code
    HQG
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    ME, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    WENT THROUGH 2 PAIRS OF GLASSES WITHIN 4 MOS. BOTH BROKE IN THE SAME PLACE. MFR, DR OR MEDICARE WILL NOT COVER THEM ON ANY TYPE OF WARRANTY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 JAMIE EYEQ EYE GLASSES +1.50 +350 HQG * 40SQ.18 125MM MAT BROWN *

    Patients

    Seq Age Sex Outcome Treatment
    1 7 YR Other