MalfunctionFAX

FILIFORM

Received Aug 11, 2003

Report 2429473-2003-00086 · MDR key 477907

Device

Generic name

Urological

Manufacturer

Model number

Catalog number

342303

Lot number

UNK

Patient

UNKNOWN

No Consequences Or Impact To Patient
Unknown (for use when the patient's condition is not known)

Narrative

Description of Event or Problem

CUSTOMER REPORTS FILIFORM DISLODGED IN PATIENT.