FDA Adverse Event
Other
Summary report: N
*
MDR report key: 504851
·
Received December 25, 2003
Report
- Report Number
- MW1030597
- Event Type
- Other
- Date Received
- December 25, 2003
- Report Date
- December 25, 2003
- Manufacturer
- *
- Product Code
- KGM
- Adverse Event
- Yes
- Report Source
- Voluntary report
- Reporter Location
- NY, US
- Reporter Occupation
- PATIENT
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | * | SILICONE | KGM | * | * | * |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 34 YR | Other |