BEUDAMED
    FDA Adverse Event Injury Summary report: N

    *

    MDR report key: 505982 · Received January 12, 2004

    Report

    Report Number
    1221601-2004-00001
    Event Type
    Injury
    Date Received
    January 12, 2004
    Date of Event
    October 8, 2003
    Report Date
    January 7, 2004
    Manufacturer
    TELEFLEX MEDICAL, INC.
    Product Code
    KDQ
    Adverse Event
    Yes
    Report Source
    Manufacturer report

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * KDQ TELEFLEX MEDICAL, INC.

    Patients

    Seq Age Sex Outcome Treatment
    0 77 YR Required Intervention