FDA Adverse Event Other Summary report: N

POLARIS PLUS HUMERAL ROD

MDR report key: 977013 · Received October 25, 2004

Report

Report Number
977013
Event Type
Other
Date Received
October 25, 2004
Date of Event
August 22, 2004
Report Date
September 1, 2004
Manufacturer
ACUMED/POLARUS/SEA PEARL, INC
Product Code
HTW
Product Problem
Yes
Report Source
User Facility report
Reporter Location
NJ, US
Reporter Occupation
RISK MANAGER

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 POLARIS PLUS HUMERAL ROD DRILL BIT HTW ACUMED/POLARUS/SEA PEARL, INC * NA

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other