BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ARTHREX INC.

    MDR report key: 504825 · Received December 27, 2003

    Report

    Report Number
    MW1030653
    Event Type
    Malfunction
    Date Received
    December 27, 2003
    Date of Event
    December 23, 2003
    Report Date
    December 27, 2003
    Manufacturer
    ARTHREX, INC.
    Product Code
    MBI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    PHYSICIAN

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ARTHREX INC. CANNULATED DELTA BIO-INTERFERENCE SCREW MBI ARTHREX, INC. AR 5035TB-10 34277

    Patients

    Seq Age Sex Outcome Treatment
    1 15 YR Other