COOK CL-2612-AC G46211

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-01-25 for COOK CL-2612-AC G46211 manufactured by Cook.

Event Text Entries

[66078369] Wire broke off into patient. The wire was found in the specimen at the end of the procedure. Diagnosis or reason for use: turp. Is the product compounded: no. Is the product over-the-counter: no.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5067511
MDR Report Key6282843
Date Received2017-01-25
Date of Report2017-01-25
Date of Event2017-01-10
Date Added to Maude2017-01-27
Event Key0
Report Source CodeVoluntary 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 Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameCOOK
Generic NameCUTTING LOOP 26 FR, .012, .012" WIRE
Product CodeKOB
Date Received2017-01-25
Model NumberCL-2612-AC
Catalog NumberG46211
Lot Number6980418
Device Expiration Date2019-05-18
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCOOK
Manufacturer AddressBLOOMINGDALE IN 47404 US 47404


Patients

Patient NumberTreatmentOutcomeDate
10 2017-01-25

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