CANCELLOUS CHIPS, 30 CC * 800150

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2004-04-24 for CANCELLOUS CHIPS, 30 CC * 800150 manufactured by Musculoskeletal Transplant Foundation.

Event Text Entries

[335880] Three examples of musculoskeletal transplant foundation cancellous bone chips. Aluminum bottle seals were not securely crimped onto bottles ie. Seals not complete. Reported to mtf via voice-mail. No response to date. These were not implanted in pt. One previous example has been returned to the supplier. Poor packaging for sterile material.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW1031931
MDR Report Key525687
Date Received2004-04-24
Date of Report2004-04-24
Date Added to Maude2004-05-21
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA0
Report to FDA0
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NameCANCELLOUS CHIPS, 30 CC
Generic NameHUMAN ALLOGRAFT TISSUE
Product CodeLMO
Date Received2004-04-24
Model Number*
Catalog Number800150
Lot Number*
ID Number*
Device Expiration Date2006-12-05
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Implant FlagY
Date Removed*
Device Sequence No1
Device Event Key514823
ManufacturerMUSCULOSKELETAL TRANSPLANT FOUNDATION
Manufacturer Address1232 MID VALLEY DR. JESSUP PA 18434 US

Device Sequence Number: 2

Brand NameCANCELLOUS CHIPS, 30 CC
Generic NameALLOGRAFT TISSUE
Product CodeLMO
Date Received2004-04-24
Model Number*
Catalog Number800150
Lot Number*
ID Number*
Device Expiration Date2006-12-05
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age*
Implant FlagY
Date Removed*
Device Sequence No2
Device Event Key514824
ManufacturerMUSCULOSKELETAL TRANSPLANT FOUNDATION
Manufacturer Address1232 MID VALLEY DR JESSUP PA 18434 US


Patients

Patient NumberTreatmentOutcomeDate
10 2004-04-24

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