BEUDAMED
    FDA Adverse Event Other Summary report: N

    OLYMPUS DSD

    MDR report key: 5508195 · Received January 21, 2005

    Report

    Report Number
    5508195
    Event Type
    Other
    Date Received
    January 21, 2005
    Date of Event
    January 13, 2005
    Report Date
    January 14, 2005
    Manufacturer
    NEDIVATORS, INC.
    Product Code
    FDA
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    DR. (B)(6) REPORTED ON (B)(6) 2005 THAT PATIENT HAD A COLONOSCOPY ON (B)(6) 20005 AT (B)(6). AFTER DISCHARGE, C/O "ABDOMINAL PAIN, CRAMPING AND RECTAL BLEEDING" VIA PHONE CALL FROM PATIENT TO M.D. OFFICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OLYMPUS DSD ENDOSCOPE REPROCESSOR FDA NEDIVATORS, INC. 201 NA
    2 OLYMPUS ENDOSCOPE FDA OLYPMUS CF0160AL

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR