BEUDAMED
    FDA Adverse Event Other Summary report: N

    MICROVASIVE

    MDR report key: 755389 · Received July 19, 2005

    Report

    Report Number
    MW1036075
    Event Type
    Other
    Date Received
    July 19, 2005
    Date of Event
    July 11, 2005
    Report Date
    July 11, 2005
    Manufacturer
    BOSTON SCIENTIFIC
    Product Code
    FFL
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NC, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PROBLEM NOTED ON CHECK PRIOR TO USE - BASKET WOULD NOT CLOSE PROPERLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MICROVASIVE 3 WIRE STONE BASKET FFL BOSTON SCIENTIFIC * *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Other