MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 04,06 report with the FDA on 2013-09-23 for OSTRUM ANTRUM PUNCH BACKBITER, LEFT 1/EA 3712033 manufactured by Medtronic Xomed Instrumentation S.a.s.
[3920077]
The device (backbiter (b)(4) ostrum antrum punch lf) was returned to mxi for service <(>&<)> repair. There was no reported patient impact.
Patient Sequence No: 1, Text Type: D, B5
[11086303]
(b)(4): the device (backbiter (b)(4) ostrum antrum punch lf) was returned for evaluation. Analysis indicated that the tip of the instrument is broken. The device is un-repairable due to the broken tip. Note: this mdr is being filed as a result of an internal review of complaints from medtronic? S mxi facility in (b)(4). This review was conducted to resolve several issues discovered in the mxi complaint handling process. Issues resolved include the misclassification of devices returned for repair, as well as gaps in reporting. (b)(4).
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 9680837-2013-00474 |
| MDR Report Key | 3363272 |
| Report Source | 04,06 |
| Date Received | 2013-09-23 |
| Date of Report | 2012-05-22 |
| Date Mfgr Received | 2012-05-22 |
| Date Added to Maude | 2014-01-02 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 0 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | SHARANYA JANGITI |
| Manufacturer Street | 6743 SOUTHPOINT DRIVE NORTH |
| Manufacturer City | JACKSONVILLE FL 32216 |
| Manufacturer Country | US |
| Manufacturer Postal | 32216 |
| Manufacturer Phone | 9043328183 |
| Manufacturer G1 | MEDTRONIC XOMED, INC. |
| Manufacturer Street | 6743 SOUTHPOINT DRIVE NORTH |
| Manufacturer City | JACKSONVILLE FL 32216 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 32216 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | OSTRUM ANTRUM PUNCH BACKBITER, LEFT 1/EA |
| Generic Name | PUNCH, NASAL |
| Product Code | KAY |
| Date Received | 2013-09-23 |
| Returned To Mfg | 2012-05-31 |
| Model Number | 3712033 |
| Catalog Number | 3712033 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDTRONIC XOMED INSTRUMENTATION S.A.S |
| Manufacturer Address | LE PAVILLON SAINT-AUBIN-LE-MONIAL 03160 FR 03160 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2013-09-23 |