BEUDAMED
    FDA Adverse Event Injury Summary report: N

    *

    MDR report key: 41150 · Received September 25, 1996

    Report

    Report Number
    41150
    Event Type
    Injury
    Date Received
    September 25, 1996
    Date of Event
    September 4, 1996
    Report Date
    September 5, 1996
    Manufacturer
    WECK
    Product Code
    HAE
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NE, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    POST LATERAL FUSION WAS BEING PERFORMED. AN EXTRACTOR WAS BEING USED BY THE PHYSICIAN IN CASE. THE SCREW FELL OUT OF THE INSTRUMENT AND WAS FOUND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * EXTRACTOR HAE WECK 388320 528742

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR Required Intervention