* 432465

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2008-07-06 for * 432465 manufactured by Phs Custom Packaging.

Event Text Entries

[20161544] Curved and straight hemostats failed to hold during circumcision of infant resulting in increased bleeding and delay in procedure.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1081381
MDR Report Key1081381
Date Received2008-07-06
Date of Report2008-07-06
Date of Event2008-06-04
Report Date2008-07-06
Date Reported to FDA2008-07-06
Date Added to Maude2008-07-28
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand Name*
Generic NamePACK, CIRCUMCISION
Product CodeOHG
Date Received2008-07-06
Model Number*
Catalog Number432465
Lot Number806840
ID Number*
OperatorPHYSICIAN
Device AvailabilityN
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key1047813
ManufacturerPHS CUSTOM PACKAGING
Manufacturer Address41980 WINCHESTER ROAD TEMECULA CA 92590 US


Patients

Patient NumberTreatmentOutcomeDate
10 2008-07-06

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