BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ULTRAMIX VAC MIX BOWL N/S SAMP

    MDR report key: 413095 · Received August 28, 2002

    Report

    Report Number
    1818910-2002-00473
    Event Type
    Injury
    Date Received
    August 28, 2002
    Report Date
    August 28, 2002
    Manufacturer
    DEPUY ORTHOPAEDICS, INC.
    Product Code
    JDZ
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    ATTORNEY REPORTS PT INFECTION. CUSTOMER USED NON-STERILE MIXING BOWL INTENDED FOR DEMO PURPOSES ONLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ULTRAMIX VAC MIX BOWL N/S SAMP MIXING APPARATUS JDZ DEPUY ORTHOPAEDICS, INC. NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Required Intervention