CRAWFORD FASCIA STRIPPER N4298 *

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2009-06-12 for CRAWFORD FASCIA STRIPPER N4298 * manufactured by Bausch & Lomb, Inc..

Event Text Entries

[1090519] Surgeon used fascia stripper to obtain fascia to be used in a blepharoptosis repair. It was very hard to use and another procedure had to be performed to obtain the fascia. When the instrument was taken to the processing room to be cleaned, it was noted that a screw was missing. The patient's leg was x-rayed and showed a retained screw. The screw was surgically removed.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1406965
MDR Report Key1406965
Date Received2009-06-12
Date of Report2009-05-11
Date of Event2008-10-23
Report Date2009-05-11
Date Reported to FDA2009-06-12
Date Added to Maude2009-06-26
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameCRAWFORD FASCIA STRIPPER
Generic NameINSTRUMENT, OPHTHALMIC PLASTIC
Product CodeHRT
Date Received2009-06-12
Model NumberN4298
Catalog Number*
Lot Number*
ID Number*
Device AvailabilityN
Device Sequence No1
Device Event Key0
ManufacturerBAUSCH & LOMB, INC.
Manufacturer Address21 PARK PLACE BOULEVARD CLEARWATER FL 33759 US 33759


Patients

Patient NumberTreatmentOutcomeDate
10 2009-06-12

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