BEUDAMED
    FDA Adverse Event Other Summary report: N

    XRA-4430

    MDR report key: 505559 · Received December 22, 2003

    Report

    Report Number
    1526809-2003-00010
    Event Type
    Other
    Date Received
    December 22, 2003
    Date of Event
    November 17, 2003
    Manufacturer
    WESTERN/SCOTT FETZER CO.
    Product Code
    CAN
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    OTHER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 XRA-4430 FLOW REGULATOR/CYLINDER ASSEMBLY CAN WESTERN/SCOTT FETZER CO. XRA-4430 *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other