BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ODP/EDM PROBE

    MDR report key: 527312 · Received November 7, 2003

    Report

    Report Number
    9680933-2003-00001
    Event Type
    Malfunction
    Date Received
    November 7, 2003
    Date of Event
    October 28, 2003
    Report Date
    October 30, 2003
    Manufacturer
    DELTEX MEDICAL LTD
    Product Code
    DPW
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UK
    Reporter Occupation
    NURSE

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ODP/EDM PROBE OESOPHAGEAL DOPPLER PROBE DPW DELTEX MEDICAL LTD ODP/EDM PROBE 1057

    Patients

    Seq Age Sex Outcome Treatment
    1 89 YR Other