CEN TURION N/A CCB I11ST

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1993-01-29 for CEN TURION N/A CCB I11ST manufactured by Tri-state Hospital Supply.

Event Text Entries

[1877] Circumcision was performed by a physician at 11:10 a. M. On 11/10/92 using a 1. 1 cm circumcision bell and insert. Small amount of bleeding post procedure. Pressure applied by physician and gauze applied. Diaper was checked at 1:00 am with no bleeding. Baby had not voided. At 2:08 pm baby was with mother. Mother called for assistance. Diaper was saturated with dark red blood. Bleeding was noted from under the edge of circumcised foreskin, dorsal side of penis. Adrenaline chloride 1:10 solution was applied to 4 x 4 gauze and pressure applied to penis. The physician was called at 2:14 pm. Bleeding continued from under skin, dorsal side of penis. Bleeding ceased at 2:18 pm. Penis wrapped in vaseline gauze and pediatrician notified. Diaper weight of saturated diaper equaled 130 cc's of blood loss. (possible baby could have voided but blood did not look diluted, dark red in color). At 2:30 pm no blood noted. At 2:40 pm scant amount of bleeding noted from circumcision. Vaseline gauze reapplied. At 3:30 pm scant amount of blood noted. No further bleeding noted after 3:30 pm. Baby was discharged in am of following day. Device labeled for single use. Patient medical status prior to event: satisfactory condition. There was not multiple patient involvement. Invalid data - on device service/maintenance. No data - regarding date last serviced. Service provided by: invalid data. Invalid data - service records availability. No imminent hazard to public health claimed. Device used as labeled/intended. Device was not evaluated after the event. Method of evaluation: no data. Results of evaluation: no data. Conclusion: no data. Certainty of device as cause of or contributor to event: unknown (cannot determine). Corrective actions: none or unknown. The device was destroyed/disposed of.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number4123
MDR Report Key4123
Date Received1993-01-29
Date of Event1992-11-10
Date Facility Aware1992-11-16
Date Reported to Mfgr1992-11-27
Date Added to Maude1993-05-13
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 Professional0
Initial Report to FDA0
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameCEN TURION
Generic Name1.1 CM CIRCUMCISION BELL & INSERT
Product CodeFHG
Date Received1993-01-29
Model NumberN/A
Catalog NumberCCB I11ST
Lot Number06292
ID NumberN/A
OperatorOTHER HEALTH CARE PROFESSIONAL
Device AvailabilityN
Device Age01-JUL-92
Implant FlagN
Device Sequence No1
Device Event Key3856
ManufacturerTRI-STATE HOSPITAL SUPPLY


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 1993-01-29

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