BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CORDIS CORPORATION

    MDR report key: 419382 · Received October 1, 2002

    Report

    Report Number
    419382
    Event Type
    Injury
    Date Received
    October 1, 2002
    Date of Event
    August 21, 2002
    Report Date
    September 3, 2002
    Manufacturer
    CORDIS CORP.
    Product Code
    DQX
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    LA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    DURING PROCEDURE, GUIDEWIRE BECAME KINKED. SURGICAL INTERVENTION REQUIRED FOR PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CORDIS CORPORATION STANDARD J-TIP EMERALD GUIDWIRE DQX CORDIS CORP. * F0602788

    Patients

    Seq Age Sex Outcome Treatment
    1 30 YR Hospitalization| L| R