CHIBA 22G, 14.9CM 0921225000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-07-27 for CHIBA 22G, 14.9CM 0921225000 manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[51235637] The reported device was discarded by the customer and not received for evaluation.
Patient Sequence No: 1, Text Type: N, H10


[51235638] It was reported the tip fractured off the device during a procedure at the healthcare facility. The tip was removed and the procedure was completed successfully. It was also reported there was no impact on the patient and no adverse consequences.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001811755-2016-01315
MDR Report Key5828276
Date Received2016-07-27
Date of Report2016-07-15
Date of Event2016-06-01
Date Mfgr Received2016-07-15
Date Added to Maude2016-07-27
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 ContactMR. CASEY METZGER
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal49001
Manufacturer Phone2693237700
Manufacturer G1STRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal Code49001
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameCHIBA 22G, 14.9CM
Generic NameDEVICE, PERCUTANEOUS, BIOPSY
Product CodeMJG
Date Received2016-07-27
Catalog Number0921225000
Lot NumberUNKNOWN
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Address4100 EAST MILHAM AVENUE KALAMAZOO MI 49001 US 49001


Patients

Patient NumberTreatmentOutcomeDate
10 2016-07-27

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