BEUDAMED
    FDA Adverse Event Other Summary report: N

    LACTOSORB BONE TAP

    MDR report key: 536142 · Received July 21, 2004

    Report

    Report Number
    1032347-2004-00016
    Event Type
    Other
    Date Received
    July 21, 2004
    Date of Event
    June 29, 2004
    Report Date
    June 30, 2004
    Manufacturer
    W. LORENZ SURGICAL, INC.
    Product Code
    HWX
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SD, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    DURING REPAIR OF ORBITAL ROOF, TAP BROKE FLUSH INTO PT'S HEAD. DOCTOR WAS UNABLE TO REMOVE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LACTOSORB BONE TAP BONE TAP HWX W. LORENZ SURGICAL, INC. * 244390

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other