RANEY SCALP CLIPS 20-1037

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2015-11-24 for RANEY SCALP CLIPS 20-1037 manufactured by Codman & Shurtleff, Inc..

Event Text Entries

[31992612] Upon completion of the investigation a follow up report will be filed.
Patient Sequence No: 1, Text Type: N, H10


[31992613] A hair was found in the sterile package. Event occurred prior to surgery, no delays, no adverse consequences; surgeon didn't open package, sent it to purchasing. On (b)(6) 2015 per rep, reported contamination inside sterile barrier.
Patient Sequence No: 1, Text Type: D, B5


[36621447] It was initially reported that the device would be returned for evaluation. Multiple attempts to obtain the sample were unsuccessful. This report has been updated to reflect the corrected information. Complaint sample was not returned to codman; therefore, an evaluation of the device could not be performed. A review of manufacturing records was performed by the supplier and no nonconformances were noted. The cause(s) of the difficulty reported by the customer could not be determined. If the complaint sample becomes available, this complaint will be reopened, and the respective evaluation performed. At present, we consider this complaint to be closed. Trends will be monitored for this or similar complaints. Device not returned.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1226348-2015-10700
MDR Report Key5245645
Report SourceCOMPANY REPRESENTATIVE
Date Received2015-11-24
Date of Event2015-11-05
Date Mfgr Received2016-01-19
Date Added to Maude2015-11-24
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR JAMES KENNEY
Manufacturer Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal02767
Manufacturer Phone5088282726
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameRANEY SCALP CLIPS
Generic NameCLIPS, SCALP
Product CodeHBO
Date Received2015-11-24
Catalog Number20-1037
Lot NumberBH607
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCODMAN & SHURTLEFF, INC.
Manufacturer Address325 PARAMOUNT DRIVE RAYNHAM MA 02767 US 02767


Patients

Patient NumberTreatmentOutcomeDate
10 2015-11-24

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