MAUDE MDR 267713

MDR report key
267713
Report number
1018233-2000-00006
Event key
0
Event type
3
Date received
2000-03-03
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#

Contact
VIVIAN STEPHENS
Address
8195 INDUSTRIAL BLVD. COVINGTON GA 30014 US
Phone
770-770-7707
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BARD BRACHYTHERAPY NEEDLESEED IMPLANT NEEDLEC.R. BARD, INC.IWJNA218201UNKNRN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12000-03-0301. O

Event Narratives#

D

Patient 1

NEEDLE BROKE OUTSIDE OF PATIENT DURING THE 2ND PLACEMENT RUN WHICH OCCURRED AFTER DOCTOR HIT BONE AND WHEN TRYING TO PASS SAME NEEDLE AGAIN.