BEUDAMED
    FDA Adverse Event Summary report: N

    UNK

    MDR report key: 521578 · Received March 29, 2004

    Report

    Report Number
    MW1031863
    Date Received
    March 29, 2004
    Date of Event
    February 18, 2004
    Report Date
    March 29, 2004
    Manufacturer
    MEDTRONICS
    Product Code
    HAE
    Report Source
    Voluntary report
    Reporter Location
    NC, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    SMALL STRAIGHT PITUITARY INSTRUMENT. THE UPPER JAW BROKE OFF IN THE DISC SPACE L4-5. TIP WAS RETRIEVED BY SURGEON, NO ADVERSE EVENT TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 UNK PITUITARY INSTRUMENT HAE MEDTRONICS G203E0058 *

    Patients

    Seq Age Sex Outcome Treatment
    1 51 YR