BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SALUTE FIXATION DEVICE

    MDR report key: 725122 · Received June 7, 2006

    Report

    Report Number
    1213643-2006-00152
    Event Type
    Malfunction
    Date Received
    June 7, 2006
    Date of Event
    May 16, 2006
    Report Date
    May 16, 2006
    Manufacturer
    DAVOL INC., SUB. C.R. BARD, INC.
    Product Code
    GDW
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ

    Narratives

    Description of Event or Problem · 1

    STRAIGHT SHOTS: RGA 2715S. RECEIVED -05/02/2006

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SALUTE FIXATION DEVICE ENDOSCOPIC STAPLER & STAPLES GDW DAVOL INC., SUB. C.R. BARD, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 YR