BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DGW .035 FC J3MM 150CM TEF

    MDR report key: 459776 · Received May 9, 2003

    Report

    Report Number
    1016427-2002-00176
    Event Type
    Malfunction
    Date Received
    May 9, 2003
    Report Date
    October 1, 2002
    Manufacturer
    CORDIS CORPORATION (MIAMI)
    Product Code
    MKI
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    BR
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    THE PRODUCT COATING WAS DAMAGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DGW .035 FC J3MM 150CM TEF CARDIOLOGY WIRES & METALS MKI CORDIS CORPORATION (MIAMI) NA UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN