MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2009-07-21 for MEDTRONIC PYRAMID 4 PYRAMID +4 4-F manufactured by Minnesota.
[1103002]
Malfunctioning forceps holder, piece broke off.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5012072 |
| MDR Report Key | 1420988 |
| Date Received | 2009-07-21 |
| Date of Report | 2009-07-21 |
| Date of Event | 2009-07-14 |
| Date Added to Maude | 2009-07-30 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MEDTRONIC PYRAMID 4 |
| Generic Name | NONE |
| Product Code | FFF |
| Date Received | 2009-07-21 |
| Model Number | PYRAMID +4 |
| Catalog Number | 4-F |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MINNESOTA |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2009-07-21 |