UNI-CLIP DRILL GUIDE * 119301

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 08 report with the FDA on 2005-04-26 for UNI-CLIP DRILL GUIDE * 119301 manufactured by Newdeal S.a..

Event Text Entries

[389603] The handle broke during the procedure. However, device could still be used and the surgeon used it to complete the surgery. There was no pt injury reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9615741-2005-00008
MDR Report Key596684
Report Source08
Date Received2005-04-26
Date of Report2005-04-26
Date Mfgr Received2005-03-29
Date Added to Maude2005-04-29
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 Location0
Manufacturer ContactYANPING WANG
Manufacturer Street311C ENTERPRISE DRIVE
Manufacturer CityPLAINSBORO NJ 08536
Manufacturer CountryUS
Manufacturer Postal08536
Manufacturer Phone6099362322
Manufacturer G1NEWDEAL S.A.
Manufacturer Street10, PLACE D'HELVETIE
Manufacturer CityLYON 69006
Manufacturer CountryFR
Manufacturer Postal Code69006
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNI-CLIP DRILL GUIDE
Generic NameUNI-CLIP IMPLANT ASSOCIATED INSTRUMENT
Product CodeHXY
Date Received2005-04-26
Model Number*
Catalog Number119301
Lot NumberCF
ID Number*
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Implant FlagN
Date Removed*
Device Sequence No1
Device Event Key586501
ManufacturerNEWDEAL S.A.
Manufacturer Address* LYON FR
Baseline Brand NameUNI-CLIP DRILL GUIDE
Baseline Generic NameUNI-CLIP IMPLANT ASSOCIATED INSTRUMENT
Baseline Model No*
Baseline Catalog No119301
Baseline ID*


Patients

Patient NumberTreatmentOutcomeDate
10 2005-04-26

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