MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2012-01-16 for JARIT MALLET * 250-404 manufactured by Integra/jarit.
[20952854]
The mallet broke while broaching right hip.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2472044 |
| MDR Report Key | 2472044 |
| Date Received | 2012-01-16 |
| Date of Report | 2012-01-16 |
| Date of Event | 2012-01-11 |
| Report Date | 2012-01-16 |
| Date Reported to FDA | 2012-01-16 |
| Date Added to Maude | 2012-02-29 |
| Event Key | 0 |
| Report Source Code | User Facility 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 | 3 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | JARIT MALLET |
| Generic Name | MALLET |
| Product Code | HXL |
| Date Received | 2012-01-16 |
| Model Number | * |
| Catalog Number | 250-404 |
| Lot Number | * |
| ID Number | * |
| Device Availability | N |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | INTEGRA/JARIT |
| Manufacturer Address | 589 DAVIES DR YORK PA 17402 US 17402 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2012-01-16 |