MAUDE MDR 2559528

MDR report key
2559528
Report number
2559528
Event key
0
Event type
3
Date of event
2012-03-23
Date received
2012-04-27
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Report source
U
Manufacturer link flag
N

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1RADIAL JAW 3FORCEPS, BIOPSYBOSTON SCIENTIFICBWH*M0051523114819365

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12012-04-270

Event Narratives#

D

Patient 1

DURING THE PROCEDURE IT WAS NOTED THAT THE JAWS OF THE FORCEPS WERE SPRUNG WHILE REMOVING A SPECIMEN FROM THE DEVICE. ALL PARTS OF THE DEVICE WERE PRESENT, BUT THE JAWS WOULD NOT CLOSE.