MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2003-12-09 for V. MUELLER PRODUCTS AND SERVICES * manufactured by Cardinal Health V. Mueller Product And Services.
[296268]
While removing the pt's tonsil using a snare, the snare wire broke. All of the wire except for a small piece was retrieved. The physician was immediately notified that a small segment of the snare wire was missing. A thorough nasopharynx exam and a direct laryngoscopy was performed. No foreign body was visualized and chest and neck x-rays were negative.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW1030520 |
| MDR Report Key | 502135 |
| Date Received | 2003-12-09 |
| Date of Report | 2003-12-01 |
| Date of Event | 2003-11-18 |
| Date Added to Maude | 2003-12-23 |
| 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 | 3 |
| Reporter Occupation | ATTORNEY |
| 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 PRODUCTS AND SERVICES |
| Generic Name | TONSIL WIRES |
| Product Code | KBZ |
| Date Received | 2003-12-09 |
| Model Number | * |
| Catalog Number | * |
| Lot Number | * |
| ID Number | * |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Implant Flag | N |
| Date Removed | * |
| Device Sequence No | 1 |
| Device Event Key | 490920 |
| Manufacturer | CARDINAL HEALTH V. MUELLER PRODUCT AND SERVICES |
| Manufacturer Address | 1430 WAUKEGAN ROAD MCGAW PARK IL 60085 US |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2003-12-09 |