BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VC10 PUMP, 115 V

    MDR report key: 869015 · Received June 12, 2007

    Report

    Report Number
    2183680-2007-00011
    Event Type
    Injury
    Date Received
    June 12, 2007
    Report Date
    June 6, 2007
    Manufacturer
    GYRUS MEDICAL INC.
    Product Code
    JCX
    PMA / PMN Number
    K951972
    Report Source
    Manufacturer report

    Narratives

    Additional Manufacturer Narrative · 1

    THE INSTRUMENT HAS NOT BEEN RETURNED TO GYRUS ACMI, INC. FOR EVALUATION TO DATE. WITHOUT THE INSTRUMENT RETURNED, A FULL INVESTIGATION CANNOT BE COMPLETED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VC10 PUMP, 115 V BERKELEY VC 10 VACUUM CURRETAGE SYSTEM JCX GYRUS MEDICAL INC. VC-10 7026015

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization| R