BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MTF

    MDR report key: 807193 · Received January 5, 2007

    Report

    Report Number
    807193
    Event Type
    Injury
    Date Received
    January 5, 2007
    Date of Event
    December 6, 2006
    Report Date
    December 26, 2006
    Manufacturer
    MTF
    Product Code
    LMO
    Report Source
    User Facility report
    Reporter Location
    HI, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    BROKEN COMPONENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MTF TISSUE LMO MTF ITEM# 058050 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 18 YR Required Intervention