MAUDE MDR 281733

MDR report key
281733
Report number
1038548-2000-00008
Event key
0
Event type
3
Date of event
2000-03-28
Date received
2000-06-14
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
500
Health professional
3
Initial report to FDA
3
Event location
3

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-LINE SWITCHBLADE METZENBAUM SCISSOR SHAFTREUSABLE SWITCHBLADESGENZYME SURGICAL PRODUCTSGEI90-1050*UNKK930666NYR

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12000-06-1401. O

Event Narratives#

D

Patient 1

THE PRODUCT INSULATION WAS ALLEGED TO HAVE HOLES IN IT RESULTING IN DAMAGE TO THE PT'S SMALL BOWEL DURING A LAPAROSCOPIC ADRENALECTOMY. COMPLAINANT SENT MDR REPORT TO FDA.