V. MUELLER ANGLED COTTLE SPRING SCISSOR * RH1701

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2014-05-20 for V. MUELLER ANGLED COTTLE SPRING SCISSOR * RH1701 manufactured by Carefusion 2200, Inc..

Event Text Entries

[4401513] Patient undergoing endoscopic frontal sinusotomy. During the surgical procedure, the end of the angled cottle spring scissor broke off into the patient's nose. The broken piece was retrieved by the surgeon and inspected to ensure all of the instrument was retrieved.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3831952
MDR Report Key3831952
Date Received2014-05-20
Date of Report2014-05-20
Date of Event2014-05-15
Report Date2014-05-20
Date Reported to FDA2014-05-20
Date Reported to Mfgr2014-05-27
Date Added to Maude2014-05-27
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameV. MUELLER ANGLED COTTLE SPRING SCISSOR
Generic NameSCISSORS, NASAL
Product CodeKBD
Date Received2014-05-20
Model Number*
Catalog NumberRH1701
Lot NumberXTA1
ID Number*
OperatorPHYSICIAN
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerCAREFUSION 2200, INC.
Manufacturer Address1500 WAUKEGAN ROAD WAUKEGAN IL 60085 US 60085


Patients

Patient NumberTreatmentOutcomeDate
10 2014-05-20

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