FDA Adverse Event Other Summary report: N

*

MDR report key: 506480 · Received December 24, 2003

Report

Report Number
MW1030669
Event Type
Other
Date Received
December 24, 2003
Date of Event
December 18, 2003
Report Date
December 23, 2003
Manufacturer
*
Product Code
LMO
Adverse Event
Yes
Report Source
Voluntary report
Reporter Location
FL, US
Reporter Occupation
RISK MANAGER

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 * GRAFT FAILURE LMO * * *

Patients

Seq Age Sex Outcome Treatment
1 50 YR Other