MAUDE MDR 2720773

MDR report key
2720773
Report number
MW5026699
Event key
0
Event type
3
Date of event
2012-08-06
Date received
2012-08-27
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Report source
P
Manufacturer link flag
N

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HALOOVERHEAD TUBE HOLDERCORE LABS, LLCIYB02-000 Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12012-08-2701. O

Event Narratives#

D

Patient 1

UNWANTED CORROSION APPEARED ON THE DEVICE, WHICH MAY CAUSE (CAUSED) STRUCTURAL DAMAGE TO THE UNIT. FURTHER INVESTIGATION IS REQUIRED.