BEUDAMED
    FDA Adverse Event Other Summary report: N

    CORLINK AAD PROXIMAL

    MDR report key: 521803 · Received October 1, 2003

    Report

    Report Number
    3003217124-2003-00006
    Event Type
    Other
    Date Received
    October 1, 2003
    Date of Event
    August 15, 2003
    Report Date
    September 15, 2003
    Manufacturer
    BY-PASS MAAKAFIM LTD.
    Product Code
    LNN
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WI, US
    Reporter Occupation
    PHYSICIAN

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CORLINK AAD PROXIMAL ANASTOMOTIC DEVICE LNN BY-PASS MAAKAFIM LTD. PROXIMAL SP205, INP 751

    Patients

    Seq Age Sex Outcome Treatment
    1 74 YR Required Intervention