BEUDAMED
    FDA Adverse Event Other Summary report: N

    SUB MUCOSAL UPP ELECTRODE

    MDR report key: 413493 · Received August 29, 2002

    Report

    Report Number
    2428235-2002-00001
    Event Type
    Other
    Date Received
    August 29, 2002
    Report Date
    August 29, 2002
    Manufacturer
    ELLMAN INTERNATIONAL INC
    Product Code
    GEI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    PT'S MOUTH WAS BURNED DURING PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SUB MUCOSAL UPP ELECTRODE STERILE ELECTRODE GEI ELLMAN INTERNATIONAL INC NA NI

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO Other