MAUDE MDR 305970

MDR report key
305970
Report number
1038548-2000-00029
Event key
0
Event type
3
Date of event
2000-10-10
Date received
2000-11-20
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
PETE STEGAGNO
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
1REES FACELIFT SCS, SERR 6 3/4"SCISSORSGENZYME SURGICAL PRODUCTSLRWNA32-5822UNKNYY

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12000-11-200

Event Narratives#

D

Patient 1

THE TIP BROKE WHILE CUTTING SOFT TISSUE DURING TRAM RECONSTRUCTION. THE PIECE THAT BROKE OFF WAS NOT FOUND. NO PT INJURY OR TREATMENT WAS REPORTED.