MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1995-08-11 for CAPLIVATOR CRESENT SNARE 6236 manufactured by Microvasive.
[18037]
Snare snapped while attempting to (close) remove a polyp @ the handle end.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 26939 |
| MDR Report Key | 26939 |
| Date Received | 1995-08-11 |
| Date of Report | 1995-02-08 |
| Date of Event | 1995-01-13 |
| Date Facility Aware | 1995-01-13 |
| Report Date | 1995-02-08 |
| Date Reported to Mfgr | 1995-01-13 |
| Date Added to Maude | 1995-10-13 |
| 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 | CAPLIVATOR CRESENT SNARE |
| Generic Name | SNARE |
| Product Code | FDJ |
| Date Received | 1995-08-11 |
| Returned To Mfg | 1995-01-13 |
| Model Number | NA |
| Catalog Number | 6236 |
| Lot Number | H 51756 |
| ID Number | NA |
| Device Availability | R |
| Device Age | 4 YR |
| Implant Flag | N |
| Date Removed | B |
| Device Sequence No | 1 |
| Device Event Key | 27722 |
| Manufacturer | MICROVASIVE |
| Manufacturer Address | 480 OKEASABT ST WATERTOWN MA 02172 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 1995-08-11 |