CORNEAL TREPHINE BLADE 7.5MM 0009711

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2010-02-25 for CORNEAL TREPHINE BLADE 7.5MM 0009711 manufactured by Medtronic Xomed, Inc..

Event Text Entries

[1423822] The attending nurse reported during a corneal transplant procedure, the donor cornea was damaged by the trephine blade and the procedure had to be cancelled until the next day. The transplant was successfully completed, and the pt was discharged. Because the procedure was postponed, which could have caused add'l risk to the pt, the incident is being filed as a mdr.
Patient Sequence No: 1, Text Type: D, B5


[8519821] Several attempts have been made by medtronic to contact the user facility risk mgr to inquire about the pt info. If add'l info is obtained a f/u report will then be filed. The customer had prepared three different corneal trephine blades for the procedure. While only one blade caused damage to the donor cornea, the customer was unsure which trephine blade was used. Two other separate mdrs (1045254-2010-00006 / 1045254-2010-00007) will be filed for each trephine blade. The facility risk mgr was contacted about the return of the product and she stated that they will not be returning the product to medtronic until the facility has completed their internal investigation of the event.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1045254-2010-00005
MDR Report Key1617429
Report Source05
Date Received2010-02-25
Date of Report2010-01-27
Date of Event2010-01-25
Date Facility Aware2010-01-27
Device Manufacturer Date2009-10-01
Date Added to Maude2010-03-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
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
Manufacturer ContactMIKE MOSBY
Manufacturer Street6743 SOUTHPOINT DR. NORTH
Manufacturer CityJACKSONVILLE FL 32216
Manufacturer CountryUS
Manufacturer Postal32216
Manufacturer Phone9042797584
Manufacturer G1MEDTRONIC XOMED, INC.
Manufacturer Street6743 SOUTHPOINT DR. NORTH
Manufacturer CityJACKSONVILLE FL 32216
Manufacturer CountryUS
Manufacturer Postal Code32216
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCORNEAL TREPHINE BLADE 7.5MM
Generic Name86 HRH
Product CodeHRH
Date Received2010-02-25
Model Number0009711
Catalog Number0009711
Lot Number64473300
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC XOMED, INC.
Manufacturer AddressJACKSONVILLE FL US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2010-02-25

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