BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    REVOLUTION

    MDR report key: 3983122 · Received July 15, 2014

    Report

    Report Number
    3983122
    Event Type
    Malfunction
    Date Received
    July 15, 2014
    Date of Event
    July 3, 2014
    Report Date
    July 15, 2014
    Manufacturer
    STRYKER INSTRUMENTS
    Product Code
    JDZ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    ME, US
    Reporter Occupation
    NURSE

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    413727 REVOLUTION MIXER, CEMENT, FOR CLINICAL USE JDZ STRYKER INSTRUMENTS * *

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR