BEUDAMED
    FDA Adverse Event Death Summary report: N

    *

    MDR report key: 542065 · Received September 1, 2004

    Report

    Report Number
    2431497-2001-00001
    Event Type
    Death
    Date Received
    September 1, 2004
    Date of Event
    July 26, 2004
    Report Date
    August 31, 2004
    Manufacturer
    SKIL-CARE CORP.
    Product Code
    KNN
    Report Source
    Manufacturer report
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    SEE ATTACHED FORM 3500A FROM: CHESAPEAKE HEALTHCARE CENTER CHESAPEAKE, VA.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * * KNN SKIL-CARE CORP. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 *