FDA Adverse Event
Malfunction
Summary report: N
6000030-2006-00073
MDR report key: 666848
·
Received January 13, 2006
Report
- Report Number
- 6000030-2006-00073
- Event Type
- Malfunction
- Date Received
- January 13, 2006
- Date of Event
- December 12, 2005
- Report Date
- January 6, 2006
- Manufacturer
- RICE CREEK MFG
- Product Code
- LKK
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | LKK | RICE CREEK MFG | 862718 | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 35 YR |