MST MALYUGIN RING SYSTEM MAL-0001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2012-02-24 for MST MALYUGIN RING SYSTEM MAL-0001 manufactured by Microsurgical Technology Inc.

Event Text Entries

[2491711] The surgeon reported to a sales rep that he had been observing sporadic instances of microscopic metal flakes coming from the cannula of the injector.
Patient Sequence No: 1, Text Type: D, B5


[9604129] Surgeon noted that he observed a silvery or carbon like particles around the incision after removing the injector. The particles were too small to remove and there has been no pt complications.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number3019924-2012-00003
MDR Report Key2474086
Report Source07
Date Received2012-02-24
Date of Report2012-02-24
Date Mfgr Received2012-01-26
Date Added to Maude2012-07-31
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer Street8415 154TH AVE NE
Manufacturer CityREDMOND WA 98052
Manufacturer CountryUS
Manufacturer Postal98052
Manufacturer Phone4255560544
Single Use3
Remedial ActionRL
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMST MALYUGIN RING SYSTEM
Generic NameIRIS EXPANDER
Product CodeHNI
Date Received2012-02-24
Model NumberMAL-0001
Catalog NumberMAL-0001
Lot NumberUNK
ID NumberNA
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerMICROSURGICAL TECHNOLOGY INC
Manufacturer AddressREDMOND WA US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2012-02-24

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