BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NUVAGEN

    MDR report key: 7029116 · Received November 14, 2017

    Report

    Report Number
    1000526113-2017-00001
    Event Type
    Malfunction
    Date Received
    November 14, 2017
    Date of Event
    November 2, 2017
    Report Date
    November 3, 2017
    Manufacturer
    BELCHER PHARMACEUTICALS,LLC
    Product Code
    KOZ
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    PATIENT RECOVERED.

    Description of Event or Problem · 1

    PATIENT HAS EXPERIENCE WITH HEADACHE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    806708 NUVAGEN NUVAGEN COLLAGEN POWDER KOZ BELCHER PHARMACEUTICALS,LLC 9066385 123456

    Patients

    Seq Age Sex Outcome Treatment
    1 40 YR Other