MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2003-01-06 for V. MUELLER TONSIL WIRE M02010-008 * manufactured by Cardinal Healthcare.
[19965278]
Physician went to snare tonsil and tonsil wire broke off into small piece. Wire retrieved. No pt harm.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW1027154 |
| MDR Report Key | 436162 |
| Date Received | 2002-01-06 |
| Date of Report | 2002-12-17 |
| Date of Event | 2002-11-11 |
| Date Added to Maude | 2003-01-08 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 0 |
| Health Professional | 3 |
| Initial Report to FDA | 0 |
| Report to FDA | 0 |
| Event Location | 3 |
| Single Use | 0 |
| Previous Use Code | 0 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | V. MUELLER TONSIL WIRE |
| Generic Name | TONSIL SNARE WIRE, 4", SIZSE 8 |
| Product Code | KBZ |
| Date Received | 2003-01-06 |
| Model Number | M02010-008 |
| Catalog Number | * |
| Lot Number | * |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Implant Flag | N |
| Date Removed | A |
| Device Sequence No | 1 |
| Device Event Key | 425101 |
| Manufacturer | CARDINAL HEALTHCARE |
| Manufacturer Address | LOCK BOX 263 213 KANSAS CITY MO 64193 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2002-01-06 |