BEUDAMED
    FDA Adverse Event Injury Summary report: N

    WISDOM SGW

    MDR report key: 416227 · Received September 12, 2002

    Report

    Report Number
    1016427-2002-00165
    Event Type
    Injury
    Date Received
    September 12, 2002
    Date of Event
    August 15, 2002
    Report Date
    September 12, 2002
    Manufacturer
    CORDIS CORPORATION (MIAMI)
    Product Code
    DQX
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SF
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE WIRE CURLED AND BENT. THERE WAS VESSEL DAMAGE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WISDOM SGW CARDIOLOGY WIRES & METALS DQX CORDIS CORPORATION (MIAMI) NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Required Intervention