BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    J&J CODMAN

    MDR report key: 401778 · Received June 20, 2002

    Report

    Report Number
    401778
    Event Type
    Malfunction
    Date Received
    June 20, 2002
    Date of Event
    April 16, 2002
    Report Date
    May 23, 2002
    Manufacturer
    J & J CODMAN
    Product Code
    JXG
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    TUBING BROKE AT LUER LOCK CONNECTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 J&J CODMAN NEURO MONITOR ICP BASIC KIT JXG J & J CODMAN * *

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR