BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MEDPORE

    MDR report key: 502778 · Received December 19, 2003

    Report

    Report Number
    502778
    Event Type
    Malfunction
    Date Received
    December 19, 2003
    Date of Event
    December 12, 2003
    Report Date
    December 19, 2003
    Manufacturer
    MEDPORE
    Product Code
    JAZ
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    NV, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    INFECTED JAW IMPLANTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDPORE SILICONE JAW IMPLANTS JAZ MEDPORE UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Other