BEUDAMED
    FDA Adverse Event Other Summary report: N

    EMORY RESPOSABLE DISS CVD

    MDR report key: 507206 · Received January 20, 2004

    Report

    Report Number
    1038548-2004-00005
    Event Type
    Other
    Date Received
    January 20, 2004
    Date of Event
    December 17, 2003
    Report Date
    January 20, 2004
    Manufacturer
    SNOWDEN PENCER, INC.
    Product Code
    GEI
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    DURING PROCEDURE A HOLE WAS FOUND IN THE PROBE OF THE INSTRUMENT AND THEN A BURN WAS DISCOVERED ON THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 EMORY RESPOSABLE DISS CVD * GEI SNOWDEN PENCER, INC. 88-5227 513090

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN