BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MULLINS CATHETER

    MDR report key: 897474 · Received August 23, 2004

    Report

    Report Number
    1318694-2004-00001
    Event Type
    Malfunction
    Date Received
    August 23, 2004
    Date of Event
    May 13, 2004
    Report Date
    August 14, 2004
    Manufacturer
    NUMED, INC.
    Product Code
    LIT
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SA
    Reporter Occupation
    OTHER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MULLINS CATHETER PTA CATHETER LIT NUMED, INC. 250 AM-0198

    Patients

    Seq Age Sex Outcome Treatment
    1 YR