MAUDE MDR 274141

MDR report key
274141
Report number
1038548-2000-00006
Event key
0
Event type
3
Date of event
1999-10-21
Date received
2000-04-14
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#

Contact
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 table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1DIAMOND-FLEX 80MM ANGLED TRIANGULAR RETRACTORRETRACTORGENZYME SURGICAL PRODUCTSGADNA89-6112UNKK946239NRN

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12000-04-1401. O

Event Narratives#

D

Patient 1

THE FACILITY REPORTED THAT THE RETRACTOR CAME APART WHEN PASSED THROUGH A TROCAR.