BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    STEVENS TENOTOMY SCS CVD 4-1/2

    MDR report key: 509982 · Received January 13, 2004

    Report

    Report Number
    1038548-2004-00002
    Event Type
    Malfunction
    Date Received
    January 13, 2004
    Date of Event
    December 29, 2003
    Report Date
    January 13, 2004
    Manufacturer
    SNOWDEN PENCER, INC.
    Product Code
    LRW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    THE TIP BROKE OFF IN A PT DURING SURGERY - MORE INFO WAS REQUESTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 STEVENS TENOTOMY SCS CVD 4-1/2 * LRW SNOWDEN PENCER, INC. 32-0709 *

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN