UNK

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2005-01-18 for UNK manufactured by Unk.

Event Text Entries

[375975] Pt in operating room having excision of intervertebral lumbar disc with fusion/refusion. Surgeon noticed downbiter pituitary rongeur was missing a screw after using it. Scrub technician did not notice if screw was missing before use. X-ray was done and no screw was found.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number567440
MDR Report Key567440
Date Received2005-01-18
Date of Report2005-01-17
Date of Event2004-12-21
Date Facility Aware2005-01-17
Report Date2005-01-17
Date Reported to FDA2005-01-17
Date Added to Maude2005-01-26
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
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
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameUNK
Generic NameDOWNBITER PITUITARY RONGEUR
Product CodeEMH
Date Received2005-01-18
Model NumberUNK
Catalog NumberUNK
Lot NumberUNK
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeUNKNOWN
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key557252
ManufacturerUNK
Manufacturer AddressUNK UNK *


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2005-01-18

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