FDA Adverse Event Injury Summary report: N

SHINOBI SGW

MDR report key: 448013 · Received March 14, 2003

Report

Report Number
1016427-2003-00060
Event Type
Injury
Date Received
March 14, 2003
Date of Event
February 13, 2003
Report Date
March 14, 2003
Manufacturer
CORDIS CORP. (MIAMI)
Product Code
DQX
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
RISK MANAGER

Narratives

Description of Event or Problem · 1

GUIDEWIRE FRACTURED AND REQUIRED REMOVAL WITH BASKET FORCEPS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SHINOBI SGW CARDIOLOGY WIRES & METALS DQX CORDIS CORP. (MIAMI) NA A0502224

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention