FDA Adverse Event Injury Summary report: N

5.0/3.7 MHZ OMNI TEE TRANSDUCER

MDR report key: 509796 · Received February 2, 2004

Report

Report Number
3003723454-2004-00002
Event Type
Injury
Date Received
February 2, 2004
Report Date
January 28, 2004
Manufacturer
PHILIPS ULTRASOUND
Product Code
ITX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IRRITATED ESOPHAGEAL TISSUE, DISCOLORATION REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 5.0/3.7 MHZ OMNI TEE TRANSDUCER 21364A ITX PHILIPS ULTRASOUND 21364A NA

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Hospitalization| O