BON GN BR 0 TC-43 2N 48" 833-213LP

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-03-18 for BON GN BR 0 TC-43 2N 48" 833-213LP manufactured by Teleflex Medical.

Event Text Entries

[40948525] (b)(4). A device history review could not be conducted since the lot number was not provided. The manufacturer will continue to monitor and trend related events.
Patient Sequence No: 1, Text Type: N, H10


[40948526] Alleged event: during use of capio sutures the small tapercut end of the suture ripped from the suture and probably got caught in sacrospinous ligament. The patient's condition was reported as fine.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004365956-2016-00161
MDR Report Key5510399
Date Received2016-03-18
Date of Report2016-02-23
Date of Event2016-01-13
Date Mfgr Received2016-02-23
Date Added to Maude2016-03-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactEFFIE JEFFERSON
Manufacturer Street3015 CARRINGTON MILL BLVD
Manufacturer CityMORRISVILLE NC 27560
Manufacturer CountryUS
Manufacturer Postal27560
Manufacturer Phone9194332672
Manufacturer G1TELEFLEX MEDICAL
Manufacturer StreetPARQUE INDUSTRIAL FINSA
Manufacturer CityNUEVO LAREDO 88275
Manufacturer CountryMX
Manufacturer Postal Code88275
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameBON GN BR 0 TC-43 2N 48"
Product CodeGAO
Date Received2016-03-18
Catalog Number833-213LP
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerTELEFLEX MEDICAL
Manufacturer AddressRESEARCH TRIANGLE PARK NC


Patients

Patient NumberTreatmentOutcomeDate
10 2016-03-18

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