D
Patient 1
DURING A ROUTINE SUB-MUCOSE RESECTION, PART OF THE INSTRUMENT BLADE ALLEGEDLY BROKE OFF. THE BROKEN PIECE IS ASSUMED TO BE LEFT BEHIND IN THE PT NOSE.
MAUDE MDR 273960
- MDR report key
- 273960
- Report number
- 1038548-2000-00005
- Event key
- 0
- Event type
- 3
- Date of event
- 1999-08-09
- Date received
- 2000-04-14
- Adverse event
- 3
- Product problem
- 3
- Patients in event
- 0
- Reporter occupation
- 2
- Health professional
- 3
- Initial report to FDA
- 3
- Event location
- 0
Manufacturer Contact#
- Contact
- MS. LEIGH GAYLE, SPECIALIST
- Address
- 5175 S. ROYAL ATLANTA DR TUCKER GA 30084 US
- Phone
- 770-770-7707
- Report source
- M
- Manufacturer link flag
- Y
Devices#
| Seq | Brand | Generic | Manufacturer | Product code | Model | Catalog | Lot | PMA | 510(k) | Implant | Evaluated | Availability |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | SERRATED KNIGHT SCISSORS | SCISSORS | GENZYME SURGICAL PRODUCTS CORP. | LRW | NA | 32-5837 | UNK | N | N | N |
Patients#
| Sequence | Received | Treatment | Outcome |
|---|---|---|---|
| 1 | 2000-04-14 | 0 | 1. O |